Learn all about breast implant double bubble in this blog post. We’ll consider what it is, why it happens, and whether there’s anything we can do to prevent it.

Any patient who has had a breast augmentation will know there are a myriad of different complications that can occur post-operatively. While complications are rare, they can definitely happen. It’s important that we take time to understand each complication to ensure we are identifying issues early. This gives us the best outlook for managing and treating each case. Of all the complications, an under reviewed topic online is double bubble. In this special blog, Brisbane Plastic Surgeon, Dr. Phil Richardson tells us all about what double bubble is, why it happens, and whether there is anything we can do to prevent it happening.

What is double bubble in breast implants?

“Double bubble deformity” is a term used for when a breast implant sits lower than the original breast fold, causing a visible indentation in the breast. This basically looks like a crease in the lower half of the breast that creates a “bubbling” effect. The diagram below provides a visual understanding of what this looks like.

As you can see in the image, the original breast fold creates a visible indentation in the breast profile. This can vary in severity. For some patients it is subtle, but for others there may be a very noticeable demarcation. This will depend on a number of anatomical factors.

What causes double bubble?

In many instances of breast augmentation surgery, surgeons need to create a new breast fold that is lower than the original fold. This could be for three reasons. Firstly, the patient might have a very short lower-pole (the distance between their nipple and breast fold is very short or disproportionate). Secondly, they might have breast folds that sit at different heights and need to be evened out. Thirdly, patients may have tuberous breasts where the lower-pole of the breast is tight and constricted. In all instances either one or both breasts will have the breast fold adjusted. The breast fold is moved by creating an incision slightly lower than the original fold, and creating the breast implant pocket accordingly. Sutures are used to secure the implant in the new pocket and with the new breast fold position.

Double bubble occurs when a new fold is created, but the original fold is still visible. This can sometimes occur because there is a difference in tissue between the area above the original fold, and the area below the original fold. The difference in tissue thickness between the two areas can create the “double bubble” effect.

How do we treat double bubble or prevent double bubble?

Preventing double bubble deformity involves strategic surgical planning. Your plastic surgeon should advise whether you are at a higher risk of developing double bubble at your initial consultation. Understanding this risk can help to inform the surgical plan. Using a dual plane implant positioning and strategic choice of breast implants can help to reduce the risk of this complication. Of course, each case is different and these techniques are not appropriate for every patient.

Treatment for double bubble deformity can manifest in a number of ways. Your surgeon may reconstruct the breast pocket, and shore the breast to reduce the different tissue thickness. In some cases, a surgeon may recommend fat transfer breast augmentation to help even out the tissue differences and soften the marked difference between the original and new fold. In some cases, a full removal and replacement of breast implants may be advised. This might include a change in implant positioning.

Conclusion

Double bubble is a rare complication that affects patients undergoing breast augmentation surgery. Understanding what it is and how it happens is essential to managing this issue. You should always consult with a fully-qualified plastic surgeon in Brisbane before making any assumptions, and ensure you understand that any surgical procedure carries risks. If you think you may have double bubble breast implant deformity, contact Dr. Richardson today to organise an initial consultation. You can view more before and afters on our Instagram.