400cc, Mod+, IMF crease, 2 wks. ago. Dual plane. Bulge evident under left breast imm. after getting home :( Not dbl. bbl., implant creating the bulge, not my tissue. Right implant is falling down now, lots of pressure/pain at crease & incision moving up on right bst. Would love answers on best way to revise? Was my pocket over-dissected? Strattice? Am going back to my surgeon to talk, but will want expert in revision to do the surgery. Won't have nipple incision, sag better than scar (to me).
Bulge After Breast Implants - What Would You Do?
Doctor Answers 14
Double Bubble after surgery.
The photographs demonstrate a double buble worse on the left. I advise my patients that a) the breasts are not symmetrical during the healing process and b) the breasts have a different appearance at 2 weeks and at 12 weeks. Be patient. Let the healing process take its course. Speak to your surgeon about massage as this my stimulate further healing. I respect your desire to limit your scars, and suspect your surgeon opted for bigger implants because you didn't want a lift.That being said, it is necessary to create a pocket big enough to position the implants properly on the breast. I doubt strattice will be necessesary as it does not appear that you require additional support, but actually just a release of the lower pole.
Postoperative care following breast augmentation deformity
While the temptation is to rush to immediate revision, most deformities following breast augmentation improve with time. The photos demonstrate a double bubble deformity with the pocket dissected below the fold and insufficient release of the inferior breast tissue. Two problems need to be approached. First, try to stabilize the inframammary fold by wearing a great supporting underwire. Second, you need to try to stretch the remaining breast tissue to accomodate the implant. This is done with a combination of massage of the breast in every direction but down as well as a support strap. Many companies make devices that push down the upper pole while supporting the fold. This will be a gradual process that will improve over 6 months. A revision could be performed at that point to stabilize the fold internally and release the breast lower pole if needed.
The lower bulge is a double bubble
The bulge you see under your breast is the implant extending below the breast fold. The breast is lifted on top of the implant and the picture is typical of a 'double bubble'. Early revision may be able to reset the fold but it may be best to wait and let the skin envelope relax and see if it will conform to the implant. A snug under wire may help in holding the breast fold in place.
Best of luck,
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It looks like you have a double bubble. A conforming bra may help "stick" the fold a bit and soften the problem. But in all likelihood you will probably need a revision. You may want to go with smaller implants and it looks like on the left you need a small lift.
You have a double bubble deformity
Your photos show a classical double bubble deformity. Your IM crease was lowered and this is why the deformity occurred. You might try wearing a tight underwire bra to push the implants up and hope the crease re-tightens in its normal position but there is a high likelihood you will need a revision.
At two weeks, it is way to early to start thinking about revision. It takes three to six months for the swelling to resolve and the tissues to completely settle. In many cases, you will be quite surprised how nice the breasts look after this time. However, if there are still issues, then the best option is to discuss your concerns with your original surgeon. If he/she does not feel comfortable with revision surgery, then hopefully they can refer you to another surgeon. However, if you surgeon is board certified by the American Board of Plastic Surgery, then they should be well trained for both primary breast augmentations and revision surgery.
Causes and correction of double bubble problem with breast implants
The pictures show what appears to be a "classic" double bubble problem. You are correct in assuming that fixing it requires expertise, though it is possible that your own surgeon is capable. The fold across the bottom of the breast is where the original bottom edge of the breast was, and if it wasn't lowered then the implant would be too high. Fixing it would involve one of several options depending on each case; one of the most useful is converting to the split muscle plane since attachment of the muscle at the level of the crease limits allowing it to stretch out and soften. If you see pulling up along the crease when you flex your pecs then this is part of the problem. In any case it is early and you would need to see what the situation is in a couple of months.
Double Bubble after Breast Augmentation
Dear LookingForAnswer2011 in Lansing:
The fold on the lower inner aspect of the breast is most likely your original inframammary fold (IMF). The bulge under it is from the implant. This can be caused by incomplete release of the (IMF), or placement of the implant too low on the chest. Since you are only two weeks after surgery, the best course of action is to allow your breasts to heal. The fold may improve with time, but even if it does not, you will have a better chance at improvement by first letting the area heal. Treatment will depend on the final result.
See the link below, and scroll down to double bubble.
Bulge After Breast Implants - What Would You Do?
Thanks for the posted photos. first way to early for a revision, wait for at least 3 months. But you need release of the old inframammary crease on both sides, more on you left. Plus other surgical manipulations to the fold areas.
Breast augmentation revision
I agree with you that revisionary surgery will likely be necessary. Physical exam is critical to evaluate your situation precisely but based on your pictures i think that reconstruction of the inframmammary fold areas with internal sutures (capsulorraphy) will afford you the best result. Allograft is probably not necessary at this time.
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