One of the less frequent but more challenging problems in revision breast augmentation is the “double bubble”. The term double bubble refers to how the breast looks. Typically it looks like there are two breasts on one side, one being above the other.
The causes of double bubble are varied as are the treatment options. In some patients, an implant is placed under the muscle when the patient actually needs a breast lift as well. The implant stays in one position while the breast tissue falls off the implant causing a double bubble. In other patients the IMF (inframammary fold) is disrupted during the surgery causing the implant to fall too low. In other cases, the inferior edge of the pectoralis muscle remains tight causing an impression in the implant. This type of double bubble does tend to improve with time as the muscle relaxes and the lower pole skin stretches out.
Most cases of double bubble will need a revision surgery. The type of surgery will depend on why the double bubble occurred in the first place. In some cases switching the implants from under the muscle to over the muscle will correct the double bubble. If the patient needs an uplift, then going over the muscle will not correct the double bubble and the patient will need an uplift. If the IMF was disrupted, this will need to be corrected either with internal sutures or Strattice or both.
As distressing as double bubble deformity can be, it is a correctable condition. To learn more about breast implants and revision breast surgery and to view before and after pictures visit my website at drdadvandplasticsurgery.com.