The double bubble deformity occurs when the lower crease of your native breast is visible overlying the lower half of the new augmented breast. This creates the appearance of a smaller native breast superimposed on a larger augmented breast. The unattractive crease is undesirable and a frequent source of dissatisfaction in augmentation patients requesting a second opinion. This should not be confused with the double bubble sign (a finding observed on radiographs of newborns and infants with bowel problems.)
Why does double-bubble occur?
Patients with breast constriction, sharply defined breast creases, short fold to nipple distance are prone to this deformity, especially if the dissection for the implant goes lower than the natural fold
Another common cause of double-bubble is when the breast implant remains in a high or even normal position, but the breast tissue and nipple sags downward. This can be seen in patients with sub-pectoral implants or capsular contracture that holds the implant up but allows the breast tissue to descend. This can occur immediately after surgery or over time as a result of pregnancy, weight change, or gravity.
How do you correct double-bubble ?
Obviously the treatment depends on the cause of the constriction. While some mild cases may improve without surgery, many will require surgical correction.
Lancing the constriction may be needed, implant location can be switched, contractures can be excised, implant size may need to be changed, mastopexy (lift) may be indicated. Double bubble deformity surgery is a challenging procedure but is highly rewarding to the revisional breast surgeon.
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