This 43 year old patient came in to meet with Dr. Pousti all the way from Mexico. She had previously had a breast lift (mastopexy)as well as breast augmentation surgery in Mexico. She was not happy with her breast size, shape, the asymmetry of the breasts, and mostly the "double bubble" deformity.

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.

The patient was very unhappy with her breasts. She is only 7 days post-op removal of her implants, replacement with saline implants overfilled to over 900cc's and correction of the double bubble deformity.

At this time, she is EXTREMELY happy with her results.