Double bubble deformity after breast augmentation surgery occurs when there is a visible line or indention above the breast crease. Fortunately, in the hands of a good plastic surgeon who knows how to “respect” the anatomies, this complication rarely happens.
Dr. Tarick Smaili, one of the leading LA plastic surgeons, says that most cases of double bubble occurs when an inexperienced doctor uses breast implants that are too big for the body, specifically the original width of the breast.
If there is a short distance between the areola complex and natural breast crease (i.e., 2-3 cm), Dr. Smaili highlights the importance of using implants that are within the confines of the patient’s anatomy to avoid visible indentions and other cosmetic problems. Taking into account the limitations of the body, he further explains, is also a good way to achieve natural-looking results from any plastic surgery procedure.
Occasionally, breast augmentation patients are advised to choose an implant size smaller than intended to avoid double bubble deformity, breast implant displacement, rippling, and other types of cosmetic-related problems.
Aside from using the “appropriate” implant size based on the patient’s underlying anatomies, the risk of double bubble could also be reduced by lowering the inframammary fold or breast crease. This technique also allows the prosthesis to be centered on the breast mound, behind the areola complex.
And with the implants settling at the center of the breast mound, the result of surgery will look natural rather than “operated.”
But despite these guidelines, sometimes the old breast crease retains its “memory,” causing visible line across the lower aspect of the breast and below the new inframammary fold.
For women with saggy breasts, using implants could aggravate the drooping appearance and possibly result in double bubble deformity caused by the loose soft tissue looking “herniated” on top of the prostheses. To avoid these complications, breast lift as an ancillary procedure is almost a mandatory requirement.
In case the double bubble deformity occurs, most LA plastic surgeons recommend a revision surgery in which the inframammary fold is reattached to the chest. It may also involve replacing the implants with smaller ones or at least within the confines of the patient’s anatomy.