You may remember Double Bubble fondly from your childhood if you were a bubble gum fan, but you don’t want to experience double bubble as an adult woman. The term refers to a post-breast augmentation condition in which bulges appear below the breast—a double bubble.
There are a few different conditions that make double bubble, also called the “four-breast effect” and “bottoming out,” a risk. Sometimes when breast implants are placed under the pectoral (chest) muscle in a woman whose natural breast tissue is already droopy, the existing breast tissue can sag below the implant. This gives the appearance of two breast creases. Many surgeons, therefore, will recommend a combination augmentation/breast lift for patients whose breasts already sag. Opting for implants placed above the muscle is also a possibility.
Other women who can be at risk for double bubble are those with a short distance between the bottom of the areola and the breast crease, or inframammary fold (IMF). Dr. Richard Rand of Seattle describes what happens when the surgeon needs to lower the IMF to accommodate an implant. “This opens up the possibility of a “double bubble” forming as the old crease retains its memory and causes an indentation across the lower pole of the breast with a new crease below that.”
This particular case can be difficult to correct post operation. Some surgeons may suggest a breast lift, others may recommend a tissue graft.
Another plastic surgeon outlines the following as reasons behind double bubble: implants that are too big for your chest wall, residual scarring from previous breast surgeries or poor positioning by the surgeon.
The good news is that double bubble is a relatively rare complication of breast enhancement surgery. But if you have reason to think it may happen to you, if you have limited lower breast skin—tuberous breasts, for example—or if you want implants below the muscle but already have sagging tissues, be sure to ask prospective surgeons about the risk.
If you have double bubble and you’re breast enlargement was quite recent, you may want to wait a while to see if there’s improvement. Most surgeons will suggest it takes several weeks, even months, for tissues to relax and settle. Consult your original surgeon first to see if the two of you can come up with a plan that appeals to both. If not, be sure to seek another plastic surgeon with extensive breast augmentation revision experience, including double bubble cases.