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Double Bubble Deformity Breast Revision in San Francisco

When breast implants are placed, they sit more superior to the breast tissue or ride slightly high. Within 3-4 weeks, the implants begin to descend with gravity and settle behind the breast mound. Breast implant pocket maturation takes about six months to complete. If the breast implant falls too far below the breast crease or fold (inframammary fold), the resulting contour deformity is called a double bubble.

Breast double bubble contour deformity and treatment in San Francisco

            Double Bubble Contour Deformity

What is a Double Bubby Deformity?

Simply put, a double bubble is a complication from breast augmentation surgery that occurs when the implant drops behind the natural crease below the breast. Also known as a double fold, it causes a bulge that develops above and below the breast crease. Once this complication has been established, it is impossible to move the breast implant upward above the crease without surgery. Early, during the first 4-6 weeks, the crease can stretch out and blend into the tissue above and below.

What are the Signs of Double Bubble Deformity?

The first sign of a double bubble is a ridge of breast tissue at the breast’s bottom. Additionally, the breast crease may be higher than normal. It may appear to sit on top of the implant, giving the illusion of two bubbles.

Double bubble deformity is also characterized by the implant pulling upwards due to muscle movement. The breast tissue appears to fall off the implant.

How Does Double Bubble Deformity Develop?

Improper implant placement

Also known as breast implant malposition, this deformity is most common when the breast implant has been placed below the inframammary fold. This placement results in breast tissues and implants that look like a separate set of breasts.


Double bubble deformity sometimes develops after pregnancy. The excess weight gained during pregnancy causes the breasts to drop, but the implants stay in place.

Women who have their breast creases and areola close together or have limited lower breast skin are more susceptible to double bubble deformity during pregnancy.

Breast Augmentation Capsular Contracture

Capsular Contracture is when the scar tissue tightens around the implant, resulting in physical and aesthetic issues. Capsular contraction often occurs within two years after a breast augmentation.

Risk Factors of Double Bubble Deformity

Anyone with poorly inserted breast implants is at risk of double bubble deformity. However, several scenarios increase the risk of the condition, including:

Heavy Implants

When your implants are too heavy for your chest wall tissue to support, the tissues stretch, making the implants move below the tight inframammary crease.

Tuberous Breast Deformity

Tuberous breasts are a congenital deformity in which the areola and breasts are distorted due to incomplete development during puberty. Tubular breasts are elongated, pointy, and wide-set. They have high breast folds and enlarged areolas, which are more susceptible to double bubble deformity.

Wrong Implant Size

The implant size chosen may be disproportionately large to your breast, increasing the chances of double bubble breasts. The surgeon may also create a pocket that is either too large or too small for the implant. A breast implant volume revision may be necessary in this case.

Scarring from Previous Breast Surgeries

Permanent scarring around the breast area may affect the positioning of the implants. Extensive scar tissue makes you more susceptible to the double bubble deformity.

How is Double Bubble Deformity Treated?

Double Bubble deformity surgical correction -Before and after correction

Double Bubble deformity surgical correction – Before and after

A patient should delay surgical treatment to allow the breast fold to stretch into the proper position and therefore resolving on its own. However, it is not advisable to use the “wait and see” approach for more than six months after breast augmentation because, by this time, the deformity is permanent.

The decision to correct the deformity depends on several factors, including patient concerns and preferences, the severity of the condition, scarring, cost, downtime, and probability and extent of improvement.

The specific breast revision surgery depends on the underlying cause of double bubble deformity. Depending on individual circumstances, a doctor may recommend breast crease modification. Inframammary fold modification is where the breast crease is tightened then raised with sutures along the bottom of the breast. This puts the implant back into the right position.

Another corrective measure for double bubble deformity is replacing the implants with new ones at the muscle’s front.

Other plastic surgeries that can correct double bubble deformity include capsulectomy, breast lift, repair or repositioning of the breast fold, and fat injections.

Schedule a consultation with Miguel Delgado, M.D., to know which breast implant revision procedure is suitable for you.

How to Avoid Double Bubble Deformity

You can reduce the risk of double bubble deformity in several ways. They include:

Sub-Glandular Placement

Sub-glandular implant placement is where breast implants are placed over the chest muscles and under the mammary gland. The implants in this procedure are called “overs” as opposed to “under” in the pectoralis muscle.

Anatomically Shaped Implants

Anatomic breast implants have a more natural shape and, as such, offer more fullness at the lower pole. They’re more stable and textured, reducing double bubble mispositioning. However, anatomic breast implants are used less today.

Dual Plane Technique

Patients with larger, sagging breasts that don’t want a breast lift can have improved results with a dual-plane technique. The pectoral muscle is released from the breast tissue and chest wall. The result is a pocket that allows the implant to expand into the lower part of the breast. This technique not only reduces the risk of a double bubble but also makes the nipple appear higher.

Appropriate Implant Size

Choosing implant sizes proportionate to your breasts is crucial to preventing double bubble deformity. While you can select higher volume implants, the natural breast fold may have to be lowered. Large implants will only increase the risk of a double bubble.

Breast Implant Revision in San Francisco to Correct Double Bubble Deformity

Miguel Delgado, M.D. is a board-certified plastic surgeon with extensive experience treating double bubble deformity. He can perform a breast revision surgery to correct the deformity and give you the much-needed confidence boost.

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