Breast revisions can be associated with size differences, shape differences or scarring related to implants or previous surgeries. They represent some of the surgeons most challenging cases. Capsular contracture and/or improper placement of implants contributing to the greatest number of patients requiring re-operation. These patients have usually had several previous procedures and are very difficult to correct.

Breast double-bubble

There are a couple different breast shape abnormalities in which the description double- bubble can be applied.

The first type of the breast "double-bubble" deformity is an obvious deformity of shape in which the round part of the breast with the implant sits at the normal level for a breast, but the natural breast tissue and nipple have sagged downward. This double bubble look can occur immediately following surgery or over time because of pregnancy, weight loss or gravity.

The second double-bubble breast deformity is sometimes seen after submuscular breast implant surgery, however it can be also be seen in both sub-muscular and over the muscle breast augmentation. This look of a double bubble can be caused because the patients natural crease is very sharp, indented or constricted, and produces an obvious groove between the nipple and the new post surgical crease is lower causing a bulge below. In some cases, this condition gradually clears up if the breast tissue at the breast crease stretch out , however if it does not, a breast revision surgery may be needed to suture the skin and breast tissue down and correct the double bubble look.
Generally there are four indications for the breast double bubble to be present.

1. The breast pocket or breast tissue is not sutured down.
2. The breast implants are sub-muscular and the breast tissue has slid off the breast implant.
3. There may be capsular contracture of the breast distorting the breast shape.
4. The breast implants are submammary and the breast itself has drooped downward.

Usually, surgical correction of this type of double-bubble look requires a breast lift (mastopexy) or pocket revision.

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