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BREAST REVISION, DOUBLE-BUBBLE
By Stuart A. Linder, M.D. | December 8, 2009
BREAST REVISION, DOUBLE-BUBBLE DEFORMITY
Patients who present frequently for breast revision surgery to my Beverly Hills as well as Las Vegas practice, present with double-bubble deformity. By definition, a double-bubble deformity is when the implant is too high or superiorly retropositioned and the skin over-drapes the implant in an unnatural appearance. This can be fixed using several different techniques due to the extent and degree of the double-bubble deformity as well as the amount skin laxity. Through the below example, the patient only required open capsulectomies, inferior open capsulotomy, releasing scar tissue, releasing the parasternal and the lateral attachments of the pectoralis major muscle, which had not been done correctly in the last three previous attempts. The entire pocket was opened up basically and the muscle was completely released along the medial as well as the lateral portion of the chest wall. This will allow the implant to settle to its normal position. In order to maintain that position, the patient will perform postoperative tissue expansion exercises as well as wear an upper pole compression band that will maintain the opening of the lower pole of the breast pocket.
Patient Pre Op Photo (another doctor) Post Op Photo Results (Dr Linder)
The postoperative result on this patient, as you can see, is an obvious, more normal appearance to the breast with lowering of the implant, which should maintain its position permanently with time. Patients are instructed to wear sports bras and athletic brassieres until four to six weeks and complete settling has occurred.
Double bubble deformities are a challenge. They require experience and judgment. Board Certified Plastic and Reconstructive Surgeons, who specialize in breast surgery, should be able to fix this unfortunately
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