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.

Hello and thank you for the question. It's best to examine you in person before giving you a definitive recommendation. You are still early in the recovery and your results will likely change over the course of next several weeks. Having said that, there appears to be some element of inframammary fold disruption, that may need to be repaired surgically. It's best to discuss these with your surgeon. Best,Pejman Aflaki, M.D.Johns Hopkins-trained plastic surgeon

Every situation is unique so the solutions will differ. You chose your surgeon because you trusted him to perform the surgery, so I would suggest you trust his opinion getting you through this complication as well. If in 6 months you still aren't happy then it may be time to discuss a revision with him. Best of luck! 

Thanks for sharing your concern. As you can see that the scar is placed lower your implant which will gradually move down. It takes 5-6 months for the breast shape to finalize.  I recommend follow ups with your surgeon. 

Hello and thanks so much for your photos and question. We always recommend that you keep in close contact with your surgeons office. In my experience, given some time, the implants will fall down into the pocket. Wearing a bra would be counter productive as you want the implants to be seated in a natural position. Sometimes a bandeau can help push the implants down and prevent them from riding upwards. All the best!!

Hello, thank you for your inquiry.  It generally takes around 6 months to a year to see your final results. It is still a bit early to determine. Your tissues will take time to relax and allow your implants to "Drop and Fluff" settling into place. Please note that this response does not substitute patient-doctor relationship.We welcome any and all patients seeking advice to come in for a complimentary consultation available for limited time only.During the COVID-19, we are offering complimentary online consultations as well as in-office consultation with social distancing and masks. Procedure done in-hospital private surgical facility while taking covid-19 precautions. We utilize UV-light to clean the air of viruses and bacteria during our consultations and surgery.We invite you to come in to discuss your options more thoroughly.  Please send us an email at info@drkaraplasticsurgery.com with the subject line: "Attention Meagan" and we will be happy to coordinate your appointment!M.Kara,MD,FRCSC (27+ years experience)- Specializing in 24 hour recovery/ out to dinner breast augmentation in-hospital private surgical facility for your added safety and peace of mind