How to get rid of double bubble?

[dayna82]

Hi,
I had a breast augmentation last year.  I started out with a B cup chest.  My breast tissue was very firm.  My surgeon recommended a 350 cc textured round gel implant placed under the muscle.  Right after surgery, I could still see my old breast crease significantly (more so on one side than the other).  I was hoping that was normal and the tissue would stretch and fill it in.  I was starting to get worried about the appearance and was looking for info online.  I was reading that it was a double bubble.  My surgeon said we will see how the tissue stretches and heals and go from there.  8 months later with no improvement he decided the implants should be removed and placed on top of the muscle.  I decided to go with a 500cc textured round implant in hopes this might stretch it out a bit more.  I had the revision done 7 months ago.  At first, it looked like it was gone, but after a few months I was starting to see it come back again on my one breast.  The past 3 months I have lost 30 lbs.  I wasn't sure if that was the reason I can see the old crease again so much more than before.  I followed up with my surgeon and he thinks it looks fine, if in a few more months it doesnt go away, he can tighten the pocket but no promice that it woudln't come back.  
I thought it was fixed for good.  I really don't want to have a third surgery but I would to make it right.  I am very self conscious about the appearance of my one breast.  I am also noticing some rippling on the outer side of that breast, even if I am standing straight and not bending over (bending over it is much worse)
Do you have any suggestions?  I have spent so much money now and I am still unhappy.

[Howard Rosenberg, MD]

I have treated similar problems with bottoming out and double bubble effect sccessfully.  While I can briefly describe the treatment, it may be somewhat difficult to understand without some detailed knowledge of newer surgical techniques.  Basically, a new or "neo-pocket" is created outside the existing capsule to elevate the implant position above the present pocket.  This will effectively eliminate the double bubble effect.

[seroma]

My suggestion would be to find a PS that specializes in breast reconstruction. I think Dr Rosenburg is referring to a different surgical techique than what you just had done (ie placing the implant subglandular rather than your first surgery under the muscle. If you use your muscles a lot like a dancer or body builder it is better to go subglandular rather than under the muscle. I am sure it can be fixed but do u really want the same Dr ? Sounds like Dr Rosenberg has experience with this complcation. Ask to see your Dr's work. How often has he fixed this particular problem? Find the Dr that has dealt w it successfully.
Best of luck to you!
Seroma

[dayna82]

Yes, my second surgery involved creating a new pocket on top of the muscle.  I wonder why that didn't solve the problem?  I mean it is not as bad as before but especially in certain lighting, I can really see the shadow.  It makes me quite self conscious.  Is there much success in going in and tightening the pocket? My doctor said it was quite simple to do, but if he tightens it, can it not stretch back?  I do not see him until November so I want to be prepared to ask the right questions to him and have as much knowledge as I can. Thanks so much for your response. I really appreciate it.