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The Risk of Double Bubble after Breast Augmentation

By Hadi Rassael on March 04, 2014

In the years following a breast augmentation, it is possible for implants or their surrounding tissue to gradually shift position. This change often presents few health risks, but nevertheless results in a patient’s desire for implant revision. One possible complication is the appearance of a “double bubble” - a cosmetic defect that alters the shape of the breast. Although rare, this condition most often requires revision surgery to restore the desired results of an augmentation. For our patients in the Washington, D.C. area, we provide the following information on identifying and treating an implant double bubble.

What Is a Double Bubble?

A double bubble is actually a generic term for a couple of different conditions. While each stems from a different cause, they both result in a misshapen appearance of the breast. A double bubble is when a second, smaller lump or “bubble” appears within the breast, specifically in the upper or lower pole. Cases range from mild to severe malformation, but the longer a double bubble goes uncorrected, the more likely it will continue to worsen. 

Types of Double Bubble Deformities

There are essentially two types of double bubbles, which are primarily distinguished by their placement within the breast:

  • Upper pole double bubble: When a bubble appears above the nipple, in the upper portion of the breast, it is most likely due to the implant’s relatively high position in the breast. This can occur immediately after surgery, when an implant fails to fall into its expected pocket within the breast, or it can occur gradually, as skin and tissue sag downward as an implant remains in place.
  • Lower pole double bubble: Also known as bottoming out, this appears as a secondary bubble under the breast, near the inframammary crease. This occurs when an implant sinks down within the breast, creating a secondary crease beneath the original one. This may be the result of excessive tissue removal from the breast pocket during surgery, but can also be caused by gravity’s effect on an implant over time.

Avoiding a Double Bubble

The best way to lower the risk of a double bubble, as well as a host of other potential complications, is to rely on a doctor with vast experience and skill with augmentation surgery. By knowing where and how deep to place the implants, your surgeon can greatly reduce the risks associated with breast augmentation.

Additionally, patients can decrease the chances of developing a double bubble by placing their implants above the pectoral muscle. Both instances of double bubble deformity tend to occur in sub-pectoral placement, as the implants are either held too high within the muscle or pushed downward from it.

Another factor to consider is implant type. Because saline implants are heavier than silicone, they are more likely to sink below the inframammary crease. However, there are other important factors that should also be considered when choosing your implant type. 

Treating Double Bubbles

Treatment for a double bubble depends on its cause and placement. For milder cases in which the breast shape has not yet been largely affected, patients may benefit by switching implants from the sub-pectoral position to the sub-glandular position (over the pectoral muscle). When implants have remained in place but the lower breast tissue appears to droop below them, a breast lift may simultaneously fix the bubble and restore the breasts to their original position. For implants that have dropped below the crease, a combination of crease revision via sutures and implant repositioning may be the best option. Alternatively, when implants are held in place by capsular contracture, revision surgery can remove the tight tissue capsules and realign the implant within its pocket.

Until you visit your doctor, it can be difficult to know the exact cause of your double bubble and the appropriate treatment for it. Visit our cosmetic surgery office for a personal assessment of your implants and any complications.

Schedule an Appointment

Come in for a consultation with Dr. Rassael and learn how we can make your augmentation procedure as satisfying and safe as possible. Or, if you are experiencing problems from a previous procedure, see how implant revision can restore your breasts to the size and shape you want. Contact us today!

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Chevy Chase Office

4407 Willard Ave
Chevy Chase, MD 20815

Open Today 9:30am - 5:00pm

More Info Directions (301) 652-9005