Muscle flex deformity? Double bubble? (Photo)

Question

I talked to my surgeon about the way my breasts look when I move/flex. He says its normal as it's under the muscle. I know people with implants unders and it doesn't look like this. did they fall lower than normal? He says the only way to fix is to place implants over the muscle instead. I would really appreciate other opinions and to know if placing the implants over the muscle is really the only way to fix this? Would using slightly bigger or smaller implants help or a different profile?

Martin Jugenburg, MD · Answer

From your photos it seems like your natural breast tissue is sliding up over the breast implant.If this bothers you a revision , downsizing your implants may be beneficial.  Speak to your plastic surgeon about your revision options

Jed H. Horowitz, MD, FACS · Answer

Stretch #deformity occurs when the breast fold is in the correct position, however, the length of the tissue between the nipple and the fold stretches. This may be due to the patient’s soft tissue inelasticity and/or the size or shape of the implant that is used. Skin laxity can change with age, pregnancy, weight changes, or heredity. Correction of this problem usually includes skin excision as part of a mastopexy (breast lift/reshaping).It may be necessary to use #ADM to further support the breast tissue if too thin. It's best to wait 6 to 12 months depending on the reason for #revision and can be up to one year see your final #result.  If you do decide on revising, a breast lift may be helpful. The intentional result of a Breast Lift (#Mastopexy) is to improve the shape and position of the breast without reducing their size. It is used especially for breasts which sag or droop (#ptosis) as a result of aging, weight loss, pregnancy, or breastfeeding. The implants further shape their breasts, restoring superior fullness or volume which may be decreased over time. In regards to implants alone, this is usually said to be mistake by patients reflecting back at the decision. Most breasts will look droopy with solely implants. They will sag more and sooner, due to the sudden and excess weight. At times it's possible for a “Snoopy” breast or #double #bubble to develop as a result. Another option is to downsize your current implants to avoid further #complications caused by excess weight.It is best to consult with your Plastic Surgeon with an in-person exam, to better confirm if this is actually your case.

Trevor M. Born, MD · Answer

Dear tubby1919Thank you for your questions and photos. An in person consult is best to determine the course of Surgery. The shape is a result of the muscle and the internal breast tissue architecture. Pocket change, downsize of implant and fat grafting are options in creating the best contour.With Warm RegardsTrevor M Born MD

Steven Wallach, MD · Answer

It looks like you have a double bubble. Correcting this would require a pocket repair and probably downsizing of your implants. Best of luck.

Tom J. Pousti, MD · Answer

I am sorry to hear about your concerns after breast augmentation surgery.

It looks like you have "double bubble" and breast implant bottoming appearance after your revisionary surgery. A "double bubble" is a cosmetically undesirable circumstance for patients with breast implants, which occurs when the breast fails to take on the shape of the implant, resulting in the appearance of a visible line showing a separation between the bottom edge of the implant and the bottom edge of the natural breast.   Double bubble "deformities" may be more striking (visible) when breast implants have bottomed out.

There are several options when it comes to revisionary surgery to improve your outcome.  One option is to eliminate the pull of the pectorals major muscle either by completely releasing it or by suturing the muscle back down, thereby placing the breast implants  in the sub glandular position.  Patients who choose to have breast implants placed in the sub  glandular position should have enough breast tissue coverage to allow for this conversion. There are disadvantages of placing breast implants in the sub glandular position (such as increased risk of breast implant encapsulation) which should be considered as you make your decisions.

Another maneuver that may be helpful is raising the inframammary fold using capsulorraphy techniques. Sometimes, depending on factors such as quality of skin along the lower breast poles, additional support provided by acellular dermal matrix or biosynthetic mesh may be very helpful. I have also found the use of acellular dermal matrix very helpful in cases where the skin/tissues are very thin and in cases of recurrent breast implant displacement. The acellular dermal matrix helps improve contour, improves irregularities caused by the underlying breast implant and/or scar tissue, and provides additional support ("sling" effect) for the breast implants.

I hope this, and the attached link, helps.

Best wishes.

Muscle flex deformity? Double bubble? (Photo)

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