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Ask Dr. Placik (Illinois) In this forum, you can ask Chicago, Illinois plastic surgeon, Dr. Otto Placik, questions about breast augmentation and other plastic surgery procedures.

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Double Bubble video, follow up questions

Old 02-15-2016, 11:22 AM
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Double Bubble video, follow up questions

Hello Dr. Placik!

I was watching your double bubble video on youtube (linked below for reference). It was very informative! I wanted to ask a few follow up questions if you do not mind.
If a patient has double bubble post breast augmentation how far post op should they be before they consider treatment options?
Is double bubble purely a cosmetic complication or does it increase the chances of bottoming out?
And lastly, can fat grafting be done at the time of the breast augmentation surgery?

Thank you for your time!

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Old 03-16-2016, 03:49 PM
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Double Bubble

Thank you BFH for watching my video.

These are all great questions.

Double bubble deformities tend to occur in a few situations:
1) in a constricted breast in which there is insufficient tissue to cover the implant
2) when the implant diameter exceeds the base diameter of the breast
3) when the implant bottoms out

In most of these situations, it is not likely to get better with time. However, I would not advise operating immediately. I usually prefer waiting 3-6 months.

While it is a cosmetic problem, it can be aggravated by incomplete muscle release with subsequent forced downward displacement of the implant with muscle contraction which will increase the tendency for bottoming out. Occasionally, when the natural breast crease is lowered to accommodate a larger implant, bottoming out may occur independent of a double bubble.

Yes, in some instances, i have preformed simultaneous fat transfer and breast implant augmentation to minimize the potential for double bubble deformity. My most common indication, is a thin individual with widely separated breasts who desires cleavage. In these patients, when placing the implants towards the middle of the chest, there may not be sufficient tissue to cover the implants and a double bubble appearance may result. I will occasionally inject fat along the cleavage area to minimize this potential.

I hope that helps to clarify the issue.

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