Breast Implant Revision · Miami Beach, FL

Double Bubble Deformity Correction

The double bubble — a visible secondary fold beneath the breast — develops when an implant descends below the natural inframammary fold while that fold persists. It requires surgical reconstruction of the fold and pocket, not just an implant swap. Dr. Tachmes specializes in this precise correction, serving patients from across Florida and the Southeast US.

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Double Bubble Deformity Correction in Miami

What Is a Double Bubble Deformity?

A double bubble deformity occurs when the breast implant descends below the natural inframammary fold (IMF) — the crease where the breast meets the chest wall — while the IMF itself remains visible as a separate contour line.

The result is two distinct curves on the lower breast: the natural breast fold above, and the implant mound below it. In photos, this creates the unmistakable appearance of a "double bubble" or double contour on the lower breast — particularly visible from the side.

This deformity is caused by implant descent past the breast fold, and it can occur in two scenarios:

  • Subglandular double bubble — the implant is placed above the muscle, and the original fold is maintained by breast tissue adhesions to the chest wall while the implant drops below it
  • Submuscular double bubble — the implant is placed below the muscle, but the original breast tissue (which has its own fold) sags independently, creating a second contour at the natural fold level while the implant sits lower

The submuscular type is more complex to correct because it involves both the implant pocket and the natural breast tissue.

Is This What You're Seeing?

Double bubble deformity appears as:

• A visible horizontal crease or indentation on the lower breast, about 1–3 cm above the breast fold

• The breast looking like it has two distinct lower curves when viewed from the side

• The nipple appearing to sit too high relative to the implant mound

• Asymmetry if only one side is affected

• The deformity becoming more prominent when raising arms or leaning forward


When Does It Develop?

Double bubble can appear shortly after augmentation (if the pocket was over-dissected inferiorly) or years later as breast tissue ptosis develops while the implant position remains unchanged.

It is also common after weight loss, pregnancy, or as natural aging causes the breast tissue to descend relative to the implant.

Causes of Double Bubble

Over-dissection of the inferior breast pocket during original augmentation — creating too much space below the fold

Oversized implants that exceed the skin envelope, causing progressive downward migration

Tuberous breast deformity — a natural breast condition with a constricted base that predisposes to double bubble after augmentation

Post-pregnancy or weight change that causes the natural breast tissue to descend while the implant stays fixed

IMF disruption during previous surgery that was not properly repaired

How Dr. Tachmes Corrects Double Bubble

Correcting a double bubble requires surgical reconstruction of the inframammary fold — the anchor point that defines the lower breast border. The specific technique depends on the cause and type:

  • IMF reconstruction — the natural fold is surgically recreated at the correct anatomical level using deep sutures anchored to the chest wall fascia. This is the critical step in most double bubble corrections.
  • Pocket redefinition (capsulorrhaphy) — the inferior capsule is sutured closed to prevent the implant from descending below the corrected fold position
  • ADM reinforcement — biologic mesh provides additional structural support to the lower pole, reducing recurrence risk in cases where the tissue is thin or previously stretched
  • Implant exchange — often a smaller implant is selected to reduce the downward pressure that caused the original deformity
  • Mastopexy (lift) — in submuscular double bubble cases where the natural breast tissue has descended significantly, a breast lift may be required to reposition the breast tissue relative to the implant

Double bubble correction has a higher recurrence risk than many other revision types. Dr. Tachmes uses a multi-layer repair approach and provides detailed post-operative positioning instructions to optimize long-term results.

Send Dr. Tachmes Your Case for Personal Review

Double bubble correction requires an individualized surgical plan. Submit your photos and history and receive Dr. Tachmes' direct assessment of your options.

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