Severe Double-Bubble Deformity Status Post Pregnancy
The patient presents with increasing painful breast deformity associated with scar tissue contracture after pregnancy. The double-bubble deformity is a reasonably common problem that I see throughout the month. These patients presents with severe encapsulation of the upper fold of the implant causing superior retroposition of the implant and a droopiness of the skin leading to severe deformity. A double-bubble breast deformity on this patient on the right shows superior retroposition of the implant with inferior displacement of the nipple areolar complex. Her six-week postop photo shows elevation of the nipple areolar complex to its appropriate position with a formal mastopexy using the inferior pedicle Wise-pattern technique and an open capsulectomy with inferior displacement of the implant, lowering it to appropriate position. The cleavage is now symmetric and even. The inframammary folds are even and the upper pole of the breast now shows good symmetry. This can be a difficult surgery. Patients need to be in sports bras or soft bras without underwire for at least six weeks in order to allow inferior repositioning of the implants over time.
Double-bubble breast deformities require skill and experience of a Board Certified Plastic Surgeons who specialize in breast revision and reconstruction surgery. Multiple planes of release and repositioning of implants must be performed correctly in order to preserve nipple areolar complex sensitivity and blood supply as well as to reposition the implant to an appropriate position.