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How Do I Know If I Have Double Bubble Deformity? As with changing to a larger implant size, some patients choose to reduce their implant size after their primary surgery. Our skill and experience acquired in complex breast reconstruction is applied to all types of corrections after previous surgeries. Breast Revision Surgery Will Be Needed Due To Any of The Following Reasons: - Desire to change (increase/decrease) the size of the breasts. There are two conditions affecting the augmented breast that are commonly referred to as double bubble deformity. These means that the breast base size in a vertical dimension must change. Most commonly revision include replacement of breast implants, reshaping of the breasts that have previously been lifted or reduced, or correction of unsightly or misplaced scars. What Happens During Breast Implant Revision? We think that you should definitely return to the surgeon who originally operated on you to seek advice as to what can be done to rectify this. Cunningham and McCue examined the reoperation rate for primary augmentation using the Mentor (Santa Barbara, California) MemoryGel Core clinical study and determined it to be 19. Replace damaged implants.
TouchMD (Cedar City, Utah) is used in my practice. The rate of implant rupture has decreased significantly over the last few years. This is often necessary to accommodate the size of a breast implant and to prevent too high of an implant position, resulting in excessive upper breast pole fullness. When an implant is placed beneath the muscle, this placement is called a submuscular or subpectoral placement. But what is it, and is it something you need to worry about? The "double bubble" is a term that often gets tossed around in breast augmentation circles, and it would not sound so frightening if it was better understood. In women who have a double bubble, there will appear to be a second crease either above or beneath the natural fold. Double bubble deformity often occurs gradually over time. Dr. Goffas' technique for correcting bottomed-out implants involves creating a new implant pocket and repairing the inframammary fold. While the breast implants won't always need to be replaced, depending on what caused your bottoming out in the first place, you may need to consider having different implants placed to avoid a repeat of the problem. Patients with double bubble deformity must have it surgically corrected through breast revision. Some procedures that are less common but more complicated are those that involve the actual repositioning of the implants due to the incorrect placement of them during the first surgery. The most obvious symptom of a double bubble is the appearance of two creases on the underside of your breast with a second bulge or bubble in between them.
Smokers will need to stop smoking for a period of time before surgery. The inframammary fold is a key landmark when performing breast implant surgery. Revision surgery can be significantly more complicated than the original surgery. This type of double bubble is less common than a Type 1 but it may occur in combination with it.
You may be dissatisfied with the size of your breasts after surgery and wish you would have gone bigger or smaller. Type 2 Double Bubble. This complication generally happens after a breast augmentation surgery in which the implants are placed behind the pectoral muscle rather than in front of it (known as a sub-muscular or an "unders" placement). Temporary or permanent changes in nipple sensation. Raising the nipple to the correct position and removing the excess lower breast skin is usually enough to fix this complication. Management of Complications in Augmentation Mastopexy Panel: panel participant. I do not allow patients to start taking supplemental vitamin E before therapy is complete, because I believe that vitamin E may act to inhibit the healing of the internal inframammary scar. Breast revision surgery is performed to correct implants that have bottomed out by either repositioning or removing the implants. ASPS Management of Complications In Plastic Surgery Symposium. Women with breast implants typically have about a two to four percent risk of double bubble deformity. While every breast is different, about 1/2 to 2/3s of breast size increase involves these breast areas. These situations require the expertise of an experienced breast surgeon.
So if this happens to you in the early post-operative period, don't worry. However, there can be some circumstances where the patients are not very happy with their new breasts. The treatment of capsular contracture is an area of great interest to Dr. Handel as he has performed clinical research on this subject and published numerous papers in medical journals about the treatment of capsular contracture. In case of breast implants, this is usually a thin membrane that remains undetectable externally. The implants were placed through an incision underneath. Tight wrapping of the shoelace is essential to prevent the implant from sneaking underneath the wrap, which could lead to a double bubble. This can also form a double bubble appearance. This breast tissue over time slides off and over the implant (thus the waterfall comparison). Sometimes, they may suddenly decide that they want smaller or larger breast implants, or they may want them to be removed altogether. When the breast is smaller, the inframammary fold or crease is higher because the existing volume only needs a certain amount of skin between the nipple and the fold to accommodate it. Sometimes the implant does not attach itself to the surrounding tissues and can rotate in the pocket.
Usually, the patient desires to have larger breasts than her primary augmentation achieved. The ability to lower the inframammary crease without surgery has changed my practice in that I am more aggressive in cases of breast ptosis, where I may need to raise the inframammary crease, because I know that I can correct for this afterward—nonsurgically. This weak crease can provide inadequate support for the implant and ultimately give way leading the implant to drop. Capsular contracture presents to some extent in around 5% of patients. Subpectoral Device Placement: Minimizing Complications.