Breast Augmentation Double Bubble

"Double bubble" deformity is the light-hearted name for a somewhat serious but uncommon breast implant complication that may occur at any time after breast augmentation surgery.

There are many scenarios in which double bubble breast deformity may occur.

Double bubble may occur if your implants are placed behind your chest muscle (bubble No. 1), and then natural breast tissue sags, known as breast ptosis, below the implant (bubble No. 2). This sagging may worsen with advancing age or following pregnancy. Placing breast implants behind the muscle, however, does not mean a woman will develop double bubble.

Another double bubble scenario occurs when your preoperative natural fold (inframammary crease) is too high. As a result, there is a visible groove between your nipple and the new lower crease. This basically separates a bulge above from a bulge below (a "double bubble").

Double bubble can also occur with:

  • Tuberous or Snoopy breasts
  • Poor breast implant placement (such as placing the implant too high)
  • Oversized implants relative to your size
  • Scarring
  • Capsular contracture

Importantly, double bubble is not always a result of surgical error.  For example, if a woman has breast implants at age of 20, has three kids and her breasts begin to sag, double bubble can occur. That said, many women develop breast sagging and don't have a double bubble because the breast implant typically migrates south with the breast.

Double Bubble Trouble Shooting

The best way to handle double bubble is to avoid developing this complication in the first place. Choose a board certified plastic surgeon with extensive breast augmentation experience. Remember that bigger is not always better when it comes to breast implant size. Listen to your surgeon. Choose implants that fit the rest of your anatomy to avoid double bubble and other breast augmentation complications.

Treatment is not always necessary. Sometimes double bubble will resolve on its own.  A "wait and see" approach is often advised for six months after breast augmentation before making any decisions about revision breast augmentation.

If it does not resolve, a breast lift (mastopexy) may be needed. Your surgeon may also reposition the implant or replace it with one placed in front of your chest muscle. He or she may also choose to modify your breast crease by making a small incision in the crease, tightening and raising it with sutures placed along the bottom of the breast. This procedure helps ease your breast implant back into its correct position.

Who Pays For Double Bubble Revision?

The method chosen to correct double bubble will depend on its cause, as well as your preferences and those of your surgeon. The cost of double bubble revision surgery varies based on the timing and the reason for the revision.

If you return to the original breast surgeon, he or she may waive the surgical fee, but you will still likely have to pay the anesthesia and facility fees. Make sure you are clear about your surgeon's revision policy during your consultation and before booking your initial breast augmentation surgery.

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    Ronald H. Schuster, MD

    10807 Falls Road, #100
    Baltimore, MD 21093
    (800) 572-1096
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    Joshua A. Greenwald, MD, FACS

    Greenwald Plastic Surgery
    166 5th Ave
    Second Floor
    New York City, NY 10010
    (914) 421-0113
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    Arnold S. Breitbart, MD

    Arnold S. Breitbart, MD
    700 Park Avenue
    New York, NY 10021
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