3 weeks post op Breast Aug. Would wearing no bra would help minimize the double bubble or can I do something else? (photos)

Even though your surgeon is in a different country, you can still send him your pictures to make him aware of your progress and double bubble. As the implant settles, the double bubble may be stretched out and dissipate.

Hi jess121975,

Thank you for the question and the photo. I understand your concern.

Bottoming out occurs when the implant falls below the current breast crease or inframammary line. It's more likely to happen with inframammary incisions, which is why I try not to use the inframammary approach to any breast surgery.

Bottoming out can also occur if an implant is too large for the breast pocket. That is why it is important to choose an implant size that's correct for your body. I perform numerous measurements in the office to determine optimal implant size for my patient's bodies.

Though rare, some women who undergo breast augmentation will develop a minor deformity known as a “double bubble,” in which additional folds appear underneath the breasts due to the implant accidentally shifting or contracting post-surgery. In most cases, the implant simply slipped too far down the chest wall and traveled behind the breast inframammary crease (the area where the lower breast meets the chest), instead of moving forward to fill the breast cavity. If left untreated, the lopsided implant will form unnatural indentations, resulting in an odd “four-breast effect” rather than the full, rounded chest the patient initially desired.

If you are concerned, please check it with your plastic surgeon for reassurance and to further discuss your options and possibility of revision.

Daniel Barrett, MD, MHA, MS

Certified, American Board of Plastic Surgery

Member, American Society of Plastic Surgery

Member, American Society of Aesthetic Plastic Surgery

When making a lower than IMF incision it’s important to mobilize the tissues adequately to accommodate the size of the new implant. Gravity will often allow the implants to sit properly and to are early in your course. I don’t think a bra will help. Just closely follow up with your surgeon. 

You are still early in your recovery.  It appears the implants have not settled yet.  Your original position of the inframammary fold has been lowered to accommodate the 620cc implants.  If any issues persists after 6 months, then your plastic surgeon can discuss any surgical management.  At this point, enjoy your results and follow up with your plastic surgeon for evaluation.  Good luck with your recovery.

Dr. E Wright

Jess.    I appreciate your concern, but I would continue to follow your plastic surgeon’s instructions and I agree that you should not wear an underwire bra at this time. I ask all my breast augmentation patients to stay away from underwire bras for six months after surgery to allow the implants to settle. As your implants settle in, your results will continue to improve. Especially considering the fact that your implants are fairly large. It may take as long as six months for the overlying skin, breast tissue and muscle to relax, allowing your implants to soften and settle. Best of luck.