Is this the start of a "double bubble"? Will it get worse over time? And is it my surgeons fault? 3 months post op. (photos)

Question

It looks like my implant hangs below the incision spot. Also that my real breast sits above my implant. I asked my doctor why it was like this and he kind of just said I should deal with it- that it happens.He said I could do surgery to fix it but isnt a for sure thing.I'm mainly concerned it will get worse. -breast aug 12 weeks ago - i workout 4-5 days a week - I did not have a breast lift -I had a small b cup -400cc silicone under the muscle -I had " rapid recovery" surgery

Richard H. Fryer, MD · Answer

I may have responded to another similar question from you earlier.  Your explanation of what is going on is quite accurate.  The implant is below the original fold.  This may have been necessary, or it may be that the implants have bottomed out slightly.  It is difficult to determine without an in-person exam.It is normal to have the incision slightly above the actual crease of the breast.  It is far better to have the incision slightly up on the breast than below the breast on the chest.As I mentioned in my previous post it is embarrassing to me that your doctor is not responding to your concerns and helping you to understand what is going on.  You paid money to have surgery.  Part of surgery is educating and helping the patients to understand issues.  I guarantee that your surgeon would be contacting his/her plumber if a recently installed water heater wasn't working correctly or they didn't understand how to adjust the settings and that plumber would help educate them and/or resolve the issue.  Your surgeon should NOT treat you any differently.  As I suggested before -- please write a review about your experience to help protect other women on this forum from a similar experience.

Tim Sayed, MD, MBA, FACS · Answer

It does appear that you have the early stages of a double bubble forming. Assessing blame is really not the appropriate way to manage through this issue if it is the case. Double bubble can happen even when surgery is done very carefully, as the crease may loosen and allow the implant to settle below the fold when it was not expected at the time of surgery. In some cases, a double bubble can form if the surgeon is trying to lower the fold, and surgeons are somewhat divided on whether it is advisable to lower the fold at all in most cases. Sometimes (like in tuberous breasts), some effort is paid to trying to lower the fold in order to accommodate a certain size implant, especially if the fold is tight. You should discuss your concerns with your surgeon and hear out the surgeon's description of what is being seen and what your options are to correct if it remains like this. Correction of double bubble can be done but does usually require additional surgery to reset the fold.

James Clayton, MD (retired) · Answer

It looks like you have descent of the left implant lower than on your right side.  This means that your healing on the left did not support the implant in the early post operative period to keep it in the proper position.  It can get worse over time.  If you started working out with chest or impact exercises such as jogging too soon after your surgery this could contribute to your problem.  You should visit again with your surgeon to see what their recommendation is for you.  The problem can be fixed, but changes with implant pockets can be a problem with some patients.

Richard P. Rand, MD, FACS (retired) · Answer

First of all, your question "is it my surgeon's fault?" is not going to get much response because it is negative and emotionally charged. You should try to remain more neutral and just ask about what could possibly explain the issues you are seeing. Also, it will be critical to re-post with preop pictures because it looks as though you had a very short distance from the crease under the breasts to the areola and that your surgeon decided to lower the crease down to fit in the implants. Your old crease may be the indentation you are seeing. "Rapid recovery" is just a marketing tool as most all plastic surgeons do the surgery in basically a rapid recovery style.

Is this the start of a "double bubble"? Will it get worse over time? And is it my surgeons fault? 3 months post op. (photos)

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Is this the start of a "double bubble"? Will it get worse over time? And is it my surgeons fault? 3 months post op. (photos)

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