Will Submuscular/subfascial Placement Help Submuscular Breast Implants with Double Bubble?

Is this window shading and a double bubble (10 weeks post-op)? Window-shading, double bubble and sagging nipples...will submuscular/subfascial placement fix this?

Doctor Answers 9

Poor Diagnosis, Poor Planning and Wrong Breast Surgery = Poor Result

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Your photograph is not very helpful but enough to suggest an all too common scenario. Either your surgeon was a non-Plastic surgeon or a Plastic surgeon who did an operation you insisted on for fear of loosing you. The photograph sows high riding implants with overly large areolas and sagging breasts.

The RIGHT operation would have been a Breast Augmentation AND Lift (with a reduction in the size of the areola. That was not done. Instead you apparently had implants placed via a periareolar incision in a ? sub muscular pocket. Depending on the experience level of your surgeon a good result may still be salvaged by performing the Breast Lift. I would NOT change the location of the implant based on this single view.

Dr. P. Aldea

Memphis Plastic Surgeon

Implant issues

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The photo is not very helpful to delineate your concerns. If you have a double bubble, the inframammary fold needs to resuspended. Window shading is the dynamic movement of the muscle with submuscular implants.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Double Bubble, Window shading breast deformity following breast augmentation.

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Window shading is a dynamic condition and you are showing a static representation of your condition.

I believe a breast lift wtih  submuscular positoning of the implant or a biplanar approach is reasonable solution to your condiiton.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Submuscular/subfascial placement help with double bubble

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Are your implants sub glandular? If yes than yes change locale or even size with a lift would be my choice. But it seems like you had a poor informed consent. Please seek in person opinions.


Corrective breast surgery

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I wonder if your surgeon discussed a breast lift with you preop?  If not, they completely missed the diagnosis of breast ptosis in you which is not corrected by an implant either above or below the muscle.  Possibly you might have denied their recommendation for the lift.

You didn't have an easy starting point for sure, but what you needed and still need is a breast lift .  The mild double bubble can be fixed at the same time and still be below the muscle.

Correction of double bubble

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It is hard to tell from the photo if you have a double bubble.  I do believe I see one.  However, from the photo it is clear that you need a breast lift.  If you truly have a double bubble, this can be addressed during the mastopexy.  The implant appears to be sitting too high as well; all these things can be addressed.  I suggest discussing your concerns with your plastic surgeon.  Hope this helps.

Tracy M. Pfeifer, MD, MS

Tracy Pfeifer, MD
Manhattan Plastic Surgeon
4.8 out of 5 stars 29 reviews

Subfascial or split submuscular placement for double bubble

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One of the things that contributes to double bubble is the fact that with submuscular placement, the muscle has to be cut off of its attachment to the rib cage just above the bottom fold of the breast. It can then heal to the scar capsule in front of the implant and pull up at that point, right where the line is that makes the double bubble. One way to tell is by flexing the muscle and seeing if it pulls up there. If that is the case, then a lift alone will not be completely sucessful. The split muscle technique puts that part of the muscle back behind the breast and re-establishes its normal position, but leaves the upper part of the muscle over the implant where it is most needed and does not contribute to contour or animation problems. Subfascial works if there is good coverage. Some examples here: http://www.baxterplasticsurgery.com/corrective_procedures.html (Note the patient with muscle flexion deformity also had double bubble) and a more thorough description here: http://www.breastimplants411.com/dbii/Articles.asp~Article_ID=585

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

Breast lift will correct double bubble after breast implants.

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Hi.  You have bad shape after breast augmentation because you probably needed a short scar breast lit in the first place.  That can be done now, and the folds under your breasts can be repaired.  Changing the position of the breast implants will not help.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Laxity of breast tissue after augmentation

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From the image you sent it appeasr you would benefit from a breast lift of some type in addition to augmentation. Changing your implants to above the muscle can improve this somewhat but you may still need a lift.

Dr Edwards

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