Technical Explanation of the Condition
Double bubble deformity in Sydney refers to a complication where a second crease forms beneath the breast, creating the appearance of two inframammary folds (two “bubbles”). As a result, the lower part of the breast can look irregular or “stepped,” particularly in a bra or fitted clothing.
This condition can occur after breast augmentation, breast lift with implants (augmentation mastopexy), implant revision surgery, or breast reconstruction. In many cases, it develops when the implant sits in a position that conflicts with the natural breast fold. In addition, it may occur when the original inframammary fold remains visible despite changes in implant position.
A/Prof Tim Papadopoulos (FRACS) assesses double bubble deformity in Sydney with detailed clinical examination and personalised planning. During consultation, Dr Tim evaluates implant position, pocket anatomy, fold position, scar quality, and breast tissue characteristics. He then discusses revision options, recovery, risks, and realistic outcomes as part of informed consent. Importantly, results vary between individuals.
What Double Bubble Deformity Can Look Like
Patients with double bubble deformity often notice visible contour irregularity under the breast. For example, signs may include:
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a visible line or groove across the lower breast
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the appearance of two creases beneath the breast
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implant sitting higher while breast tissue sits lower (or vice versa)
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an unnatural lower-breast contour or “double curve”
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asymmetry between the breasts
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discomfort or bra-fit problems (selected patients)
In addition, double bubble deformity may become more obvious when the patient raises the arms or changes posture.
Why Double Bubble Deformity Happens
Double bubble deformity can occur for several reasons. However, the key issue typically involves a mismatch between the implant pocket, the breast tissue, and the inframammary fold.
Contributing factors may include:
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a naturally high or tight inframammary fold
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a short distance from nipple to fold (tight lower pole)
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tuberous breast anatomy (selected patients)
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implant placement changes that do not fully reset fold position
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implant malposition (especially when implants sit too high)
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inadequate release of the lower pole during augmentation
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capsular contracture affecting implant position
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revision surgery history causing altered anatomy
Because anatomy varies widely, not every patient has the same risk.
Double Bubble Deformity vs Other Implant Problems
Several implant complications can appear similar. For this reason, proper assessment matters.
Double bubble vs bottoming out
Bottoming out occurs when the implant drops too low due to weak fold support. By contrast, double bubble involves two fold lines and a contour step-off.
Double bubble vs implant malposition
Implant malposition refers broadly to implant displacement. Double bubble is a specific contour deformity often associated with fold mismatch.
Double bubble vs capsular contracture
Capsular contracture may cause firmness, distortion, pain, or elevated implant position. However, double bubble primarily creates a visible lower breast contour irregularity.
Therefore, Dr Tim confirms the diagnosis during consultation before recommending treatment.
Treatment Options for Double Bubble Deformity in Sydney
Treatment depends on the cause of the deformity, implant position, capsule features, and breast tissue quality. Therefore, treatment is always individualised.
In most cases, established double bubble deformity does not resolve without surgery. Instead, revision surgery is typically required to correct fold position, implant pocket anatomy, or tissue support.
Surgical Treatment: Double Bubble Deformity Revision Surgery
Revision surgery aims to restore a smooth lower-breast contour and create a stable, natural inframammary fold.
Dr Tim may recommend one or more of the following strategies:
Inframammary fold (IMF) correction / fold reconstruction
Fold correction aims to reshape the inframammary fold so the breast contour looks smooth and balanced. Depending on anatomy, Dr Tim may:
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reset the fold position
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recreate fold definition
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stabilise the fold to prevent recurrence
Pocket adjustment (capsulorrhaphy / capsulotomy)
If pocket shape contributes to the deformity, Dr Tim may adjust the pocket internally. For example, surgery may involve:
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tightening sections of the implant pocket (capsulorrhaphy)
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releasing restrictive capsule tissue (capsulotomy)
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improving implant centring and symmetry
Implant exchange (selected patients)
In selected patients, implant exchange may improve shape and stability. Dr Tim may discuss:
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changing implant size or projection
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reducing implant weight
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altering implant shape where appropriate
Pocket change (selected patients)
If implant plane contributes to the problem, Dr Tim may recommend changing the implant pocket, such as:
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subglandular → submuscular (selected patients)
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submuscular → subfascial (selected patients)
Breast lift (mastopexy) (selected patients)
Some patients have tissue descent over the implant, especially after pregnancy, weight loss, or prior surgery. In that case, revision surgery may include breast lift techniques to:
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reshape the breast envelope
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improve nipple position
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restore breast-to-implant harmony
Correction for tuberous breasts (selected patients)
When tuberous breast anatomy contributes to double bubble deformity, Dr Tim may incorporate additional techniques to improve lower pole expansion and contour.
Recovery and Important Considerations
Recovery depends on the complexity of revision surgery. However, most patients can expect:
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swelling and tightness early in recovery
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restrictions on heavy lifting and upper-body training
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supportive garments as advised
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staged return to work and exercise
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follow-up visits to monitor healing and implant stability
Because revision surgery involves altered anatomy and scar tissue, careful aftercare matters. Therefore, Dr Tim provides detailed recovery instructions and structured follow-up.
Suitability for Double Bubble Deformity Surgery in Sydney
Patients may be suitable for revision if they:
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notice a visible step-off or crease deformity
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experience asymmetry after augmentation or revision
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have discomfort, implant dissatisfaction, or bra-fit issues
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have stable general health
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accept scarring and recovery requirements
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do not smoke (or can stop prior to surgery)
Suitability for double bubble deformity correction in Sydney is confirmed during consultation.
Disclaimer:
All surgical procedures carry inherent risks. The information provided here is general in nature and should not be used as a substitute for an in-person consultation with a qualified specialist. Individual outcomes vary based on anatomy, healing, and adherence to post-operative care. A/Prof Tim Papadopoulos will discuss the potential risks, benefits, and realistic expectations during your consultation.
Safety, training and professional standards
A/Prof Tim Papadopoulos is a Specialist Plastic Surgeon (FRACS) and is registered with the Australian Health Practitioner Regulation Agency (AHPRA). He is also a member and Past President of the Australasian Society of Aesthetic Plastic Surgeons (ASAPS).
Patients can also consult the Royal Australasian College of Surgeons (RACS) for information on surgical training and standards.