How To Correct Double Bubble Deformity
Double bubble breast deformity is a reasonably common deformity that Dr. Linder sees in his breast revision practice, associated with the implants superiorly retropositioned, meaning that the implant rises up and looks extraordinarily unnatural. The skin will often end up along the lower pole of the breast and will end up with a hanging appearance. This can usually be corrected by performing an open capsulectomy, removing and releasing all of the scar tissue, an inferior capsulotomy, releasing the capsule on the bottom of the breast so that the implant can fall to a normal position. If there is significant skin redundancy, a formal mastopexy using the Wise-pattern technique, that is skin around the nipple areola along the vertical plane and along the inframammary fold, or an anchor scar will be performed.
Repairing a patient with double-bubble deformity requires skill. Some times patients have multiple operations and the problem becomes worse after each subsequent surgery. In this specific case, her preoperative photo shows her breasts, especially the left one, to be superiorly retropositioned. The implant is way too high. The muscles have not been released appropriately along the parasternal, medial and lateral inframammary fold, leading to a catcher's mitt-like phenomenon, pushing the implant up superiorly causing the double-bubble deformity. The patient has had three unsuccessful operations to correct this.
In any case, the postoperative results show a more normal position to the implant with complete release of the parasternal and the lateral inframammary attachments of the pectoralis major muscle, inferior open capsulectomy and inferior open capsulotomy. The implants were replaced with high profile saline implants and the patient wore an upper pole compression band in order to push the implants inferiorly along the lower portion of the breast, keeping and maintaining the open pocket along the inframammary fold. The patient's postoperative results are shown. Fixing a double-bubble deformity requires skill, experience and judgment, that of which a Board Certified Plastic and Reconstructive Surgeon should perform in order to yield a successful result.
Mark Bingaman published an article on breast capsulotomy receovery where he discusses issue on breast revision surgery and references Dr. Stuart Linder as well as the Mayo Clinic and the American Society of Plastic Surgeons with respect to their article.
Stuart A. Linder, M.D., F.A.C.S. is a Beverly Hills plastic and reconstructive surgeon specializing in breast augmentation, liposuction, tummy tuck, and more.
Dr. Linder is certified by the American Society of Plastic and Reconstructive Surgeons and is a diplomate of the American Board of Plastic Surgery.
READ ARTICLE
Skin Deep Magazine
"Reasons For Reoperation:
Breast Revision Surgery"
Contributing Writer:
Dr. Stuart A. Linder,
Board Certified Plastic Surgeon
January 2006
