Complications after breast augmentation are relatively rare, but they do occur on occasion. In many cases, such as when a patient experiences an issue known as “double bubble,” the only remedy is additional surgery. When double bubble correction becomes necessary, it is essential that you select a plastic surgeon that will take the time needed with you to accurately assess your situation and develop an appropriate revision surgery for you. Dr. Barrett has extensive experience in breast revision surgery and will work with you to correct the problem and produce an optimal outcome.
From Dr. Barrett
“The double bubble complication is typically seen after a breast augmentation is performed by a non-qualified individual. It’s essentially a mismatch of implant to the patient’s breast and can be extremely difficult to fix. One of my patients had her original surgeon tell her to roll around on the ground to correct the problem. I’ve never heard anything so absurd. We were able to correct this patient’s deformity after a lollipop lift and pocket repair but she had to undergo additional surgery and ultimately ended up with more scars than she signed up for.”
What is Double Bubble?
Double bubble is a rare and relatively minor deformity in which folds appear underneath the breasts due to implant accidentally shifting or contracting after surgery. In most cases, the implant slips too far down the chest wall and travels behind the breast inframammary crease (the area where the lower breast meets the chest), instead of moving forward to fill the breast cavity. If left untreated, the lopsided implant will form unnatural indentations, resulting in an odd “four-breast effect,” rather than the full rounded chest the patient initially desired.
There are numerous reasons why a double bubble might occur:
- Breasts begin to sag after augmentation surgery, leading to the implant dropping
- The surgeon creates a pocket that is too small or too large for the size of the implant
- Implant size chosen is disproportionately large for the breast
- A breast lift is not performed with augmentation, despite significant breast sagging
- The patient gets pregnant after augmentation, leading to changes in the breasts
- Capsular contracture, the formation of excess scar tissue, occurs after augmentation surgery
No matter what the cause of the double bubble might be, the best course of action to address this complication is usually surgery. Dr. Barrett will assess your personal situation to determine whether this is the right approach for you.
Do You Need Double Bubble Correction?
The most obvious candidates for double bubble correction are women that suffer from any of the following:
- Poor implant positioning by the surgeon
- Excessively large implant size
- Breast changes after pregnancy
- A buildup of scar tissue after augmentation surgery
While it is best to manage this condition by preventing it before it occurs, there are situations where the double bubble can arise even after a successful augmentation process. To determine whether you are at risk for the double bubble, we recommend scheduling a consultation with Dr. Barrett so that he can answer any concerns you might have.
Making the Right Choice in a Plastic Surgeon
When complications arise after breast augmentation surgery, the process to correct the issue can be more complicated than the initial procedure. Scar tissue, implant removal and damage to the underlying structure can make revision surgery much more challenging. Also, your revision surgeon must try to use the same incisions as the original surgery to prevent additional scarring. Experience and expertise are paramount to a successful revision process. Fortunately, Dr. Barrett has the necessary knowledge and will take the appropriate amount of time to ensure your follow-up surgery is as safe and successful as possible.
Options in Double Bubble Correction
Double bubble correction nearly always involves a surgical procedure. However, the technique used may differ based on the reason behind the complication. Some of the options might include:
- Removing current implants to replace them with a more appropriate size or profile
- Eliminating scar tissue that has built up since augmentation
- Lifting the breast to a perkier position on the chest wall
- Restructuring the breast pocket to hold the implant more securely
- Reconstructing the breast crease to resist downward movement of the implant
Dr. Barrett will determine the best technique for you. In some cases, a combination of these procedures will be performed to produce an optimal result for you.
Preparing for Your Procedure
Like your initial breast augmentation, the steps you take to prepare for your revision surgery will be vital in ensuring a safe operation and a successful outcome. Dr. Barrett will provide you a full set of pre-operative instructions at your initial consultation, which might include:
- Stop smoking six weeks before your surgery or more to prevent complications
- Refrain from some medications like aspirin and non-steroidal anti-inflammatories
- Do not take supplements that could exacerbate bleeding like vitamin E and St. John’s Wort
- Take sufficient time off work to allow for plenty of rest and recovery time
- Line up someone to take you home after surgery and remain with you for a day or two
- Fill prescriptions early, so they are ready when you arrive home after your procedure
If you have any questions in the days or weeks leading up to your surgery, be sure to give our office a call. We want you to have all the information necessary to feel comfortable going into your procedure.
Dr. Barrett may perform double bubble correction under general anesthesia or local anesthesia with IV sedation. He will make every effort to place your new incisions in the same location as your previous ones to avoid additional scarring. In some cases, new incisions may be necessary to produce the best result. During the procedure, Dr. Barrett will remove or reposition your current implants, adjusting the breast pocket and placing new implants if needed. He will also take out any scar tissue inside the breast that is affecting the positioning of your implants.
Dr. Barrett will likely give you an estimate of how long your procedure will take at your initial appointments, based on the amount of correction he determines you need. Once your surgery is completed, you will remain in our recovery area for a few hours before you are released to go home. Because you will be given anesthesia for your operation, you will need to have someone else drive you and preferably remain with you for at least a day or two to ensure your recovery process begins smoothly.
After Your Double Bubble Correction
The typical recovery period after breast revision surgery is approximately six weeks. We recommend our breast revision patients take at least one week off work after their procedure to encourage positive healing and minimize visible scarring afterward. During the first two weeks of recovery, it is normal to experience some soreness and swelling. Dr. Barrett will prescribe oral medication to help keep you comfortable during this time. He will meet with you in his office once a week for six weeks for follow-up checks. During the first two weeks, he will be removing the layers of stitches he placed at the time of your surgery. The incisions will be taped each time to keep them closed while they heal.
Once the taping period is completed, you will be prescribed a patented silicone scar gel to apply twice a day for three months to support the rest of the healing process. Dr. Barrett will provide more specific instructions on how to best care for yourself during the recovery period that are customized to your condition and surgery. Rest assured that since Dr. Barrett will be monitoring your recovery personally, he will be able to advise you throughout the process to prevent complications and promote a healthy and successful recovery process.
Loving Your Breasts Once Again
It can be very frustrating to undergo breast augmentation surgery, only to find the results do not meet your expectations. Dr. Barrett understands this frustration and will work closely with you during the revision process to ensure you have a better outcome the second time around. To learn more about double bubble or methods to correct it, contact Barrett Plastic Surgery today at 310-598-2648.