Severe Double Bubble Deformity
There are two types of double bubble deformities that are primarily distinguishable by their placement within the breast. The upper pole double bubble appears above the nipple, most likely due to the implant being in a relatively high position in the breast. The other is called lower pole double bubble (known as bottoming out), which is under the breast near the inframammary crease. This lower pole occurs when the implant moves down with the breast, creating a secondary crease. In many cases, the longer a double bubble breast deformity goes uncorrected, the more severe the deformity becomes.
Case Study #1
Double Bubble Deformity, Severe Breast Deformity
This is an excellent case example of a patient with severe encapsulated superior retropositioned implants with a double bubble deformity with an overhanging of the nipple-areolar complex. She desired reconstruction, however, declined any significant scarring, including inverted T. I decided upon a bilateral periareolar lift with complete release of the parasternal muscle attachments and inferior displacement of the implants through a total open capsulectomy. Her post-operative results of three weeks show excellent healing and bilateral repositioning of the nipple. She continues to wear an upper pole compression band. Sutures were removed three weeks post-op, and she continues to wear the Dr. LinderBra™ for six weeks. Notice the reshaping of the breast without a lift or an inverted T, but simply due to the superior periareolar lift and repositioning of the implant to its proper position, the nipples now show some white underneath the areolar, which indicates good placement of the nipple-areolar complex.
Patients with severe double bubble breast deformity can have periareolar lifts without inframammary scars if they are the correct candidate.
Case Study #2
Severe Double Bubble Breast Deformity With Combined Capsular Contracture, Baker IV
Below is an excellent case of a patient who has undergone bilateral breast reconstruction for breast cancer mastectomy. The left implant had ruptured, and the right implant shows a severe double bubble breast deformity with superior retropositioning of the implant. Her surgery was performed by a different surgeon approximately 12 years ago. She has had increasing scar tissue on both breasts leading to complete rupture of the left implant. The right implant has taken on a very odd shape, it is deformed and shows a severe Baker IV capsular contracture. The post-operative photograph shows bilateral open periprosthetic capsulectomy, circumferential open capsulotomy and removal, and replacement with high profile saline implants. After three and a half months, the patient’s implants have fallen to a reasonable level, and she is pleased with her final appearance.