What does correction involve?
Adjusting the implant pocket, breast fold, breast tissue, or a combination of these.
Implant exchange, removal, or a breast lift may also be discussed, depending on your anatomy and goals.
Breast & Chest
Double-Bubble Deformity Correction
Double-bubble deformity correction is revision breast surgery that addresses a visible second crease or contour beneath a breast after implant surgery.
Is this the same as bottoming out?
No, although the two can occur together.
Bottoming out means the implant has moved too low. A double bubble describes a second contour, often where the original breast fold remains visible over an implant.
Will I need new implants?
Not necessarily.
Your surgeon will consider implant condition, size, position, tissue support, and your preference about keeping implants.
01 · Overview
Understanding the extra breast crease
A double-bubble contour creates two curves along the lower breast instead of one continuous curve. It can happen when an implant extends below the original breast fold while that fold remains visible. The relationship between breast tissue and the implant can also contribute.
Correction is a form of breast implant revision, not simply another augmentation. Your surgeon may change the pocket that holds the implant, repair the lower fold, exchange the implant, or reshape the breast tissue. The plan depends on why the contour developed. [1]
An examination helps distinguish a double bubble from bottoming out, breast tissue sagging over an implant, or tightening of the scar capsule around an implant. These concerns can overlap but may need different treatments. Bring previous operative reports and implant information if available.
- Procedure type
- Individualized breast revision surgery
- Main focus
- Breast fold and implant position
- Anesthesia
- Often general anesthesia
- Recovery
- Depends on the extent of revision
Why does the original fold sometimes remain visible?
The breast fold contains firm tissue attachments. If an implant sits below those attachments, the old fold may still indent the breast. A tight lower breast or limited tissue coverage can make the extra contour more noticeable.
Does every double bubble need surgery?
No. If the change is mild, stable, and not troubling you, observation may be reasonable after assessment. A new or changing contour, pain, or swelling should be evaluated rather than assumed to be only a cosmetic issue.
02 · Concerns & Goals
What you may notice
An extra crease can change how your breast looks or feels. Your surgeon will assess the cause before recommending a correction.
A second lower crease
You may see an indentation across the lower breast with another rounded curve beneath it.
Uneven breast contours
One breast may sit lower or have a more visible crease than the other.
An implant that feels too low
The implant may extend below the intended fold, sometimes changing how bras fit.
Changes after prior surgery
A contour that appeared or became more noticeable after augmentation or revision deserves an assessment of the implant, capsule, and breast tissue.
03 · Options
How the approaches differ
These approaches may be combined. Your surgeon should explain which part of the anatomy each proposed step is intended to address.
Pocket and fold repair
Repositions the implant and rebuilds support at the lower breast fold.
How it worksInternal stitches may tighten an enlarged pocket or establish a more suitable fold position.
May suitMay suit an implant that has moved below the intended fold.
Main tradeoffThe repair can stretch or recur, especially when tissue support is weak.
Release and pocket adjustment
Addresses a persistent original fold or an unsuitable implant pocket.
How it worksThe surgeon may selectively release tight attachments or move the implant into a different pocket.
May suitMay suit a retained fold that indents the breast over the implant.
Main tradeoffRelease must be carefully balanced against the need to preserve lower-breast support.
Implant exchange or removal
Changes or removes the implant contributing to the contour.
How it worksA different implant size or profile may be paired with pocket repair; removal may be paired with reshaping.
May suitMay suit an implant that is poorly matched to the tissues or a preference to stop having implants.
Main tradeoffBreast volume and shape will change, and loose skin or an indentation may remain.
Breast tissue reshaping
Addresses breast tissue that does not sit smoothly over the implant.
How it worksA lift may reposition loose tissue. Selected cases may use fat grafting to soften a remaining contour irregularity.
May suitMay suit sagging tissue or limited coverage after the underlying structural problem is addressed.
Main tradeoffA lift adds scars; fat grafting may need repeat treatment and does not replace a needed fold repair.
Breast revision may involve implant exchange, pocket adjustment, or a lift. No single technique is appropriate for every double-bubble contour. [1] [2].
Will internal support material be needed?
Some surgeons consider mesh or other support material when tissues are weak or a repair has failed. It is not needed for everyone. Ask about the specific product, its intended use, added cost, and risks such as infection or fluid collection.
Can fat grafting alone fix the problem?
Fat grafting may soften a small indentation, but it generally cannot correct a low implant or rebuild an unstable fold. Your surgeon should explain whether the concern is mainly a surface contour issue or a structural one.
04 · Results
What may improve and what may remain
Contour improvement
The goal is a smoother transition along the lower breast.
- A faint crease or some asymmetry may remain.
- Existing scars, tissue thickness, and previous operations can limit the change.
Settling takes time
Early swelling does not show the final contour.
- The breast shape can continue changing for several months.
- Your surgeon will follow fold position, implant position, and scar healing.
Long-term support varies
A repair may improve position without preventing all future changes.
- Aging, weight changes, pregnancy, and tissue stretching may alter the result.
- The crease or implant displacement can return, and further surgery may be needed.
Revision results depend on the starting anatomy and healing. Breast implants are not lifetime devices and may require future surgery. [1]
05 · Recovery
Planning your recovery
Recovery at a glance
- Stay after surgery
- Determined by Your Surgeon
- Initial recovery at home
- Varies by Individual
- Return to desk work
- Varies by Procedure and Work Activity
- Light daily activities
- Based on Individual Recovery
- Strenuous exercise
- Based on Surgeon Clearance
Returning to work does not mean fully healed. Follow your surgeon’s instructions; strenuous activity requires clearance.
Recovery depends on whether treatment involves a limited pocket repair or additional implant exchange, lift, or fat grafting. Your surgical team's instructions take priority over general timelines.
Step 1 · Day of surgery
Treatment day
The team monitors you after anesthesia and explains dressings, medications, and any drains. Arrange a ride home and adult help as directed.
Step 2 · First several days
Early healing
Soreness, swelling, bruising, and tightness are common. Follow your individualized plan for incision care, support garments, and movement.
Step 3 · Following weeks
Gradual return to routine
Light daily activities may become easier before lifting or exercise is safe. Returning to work does not mean the internal repair has fully healed.
Step 4 · Following months
Settling and scar changes
Swelling gradually decreases and scars mature. Keep follow-up visits so your surgeon can assess the contour and the stability of the repair.
Planning everyday activities
ActivityGeneral planning contextWhat affects the plan
Desk workPlanning context: Some people return within one to two weeks; more extensive revision may need longer.What affects it: Pain, fatigue, commuting, and the scope of surgery
DrivingPlanning context: Resume only when cleared, off impairing medication, and able to steer and brake comfortably.What affects it: Alertness, arm movement, and safe emergency maneuvers
Lifting and exercisePlanning context: Usually restricted for several weeks, with a gradual return approved by your surgeon.What affects it: Stress on the repaired fold, pocket, and incisions
Sleep and bra usePlanning context: Ask which positions and garments protect your particular repair. [3]What affects it: Pressure on the breasts and support during healing
Do not start massage, compression, or breast exercises unless your surgeon recommends them. Ask your surgical team whether compresses are appropriate and exactly how to use them.
Before your procedure
- Gather prior operative reports, implant cards, and details of earlier complications.
- Share your medications, supplements, allergies, and medical history.
- Discuss nicotine use and the team's requirements before and after surgery.
- Ask whether breast imaging or implant evaluation is needed before revision.
- Arrange transportation, home support, and help with lifting or childcare.
- Confirm medication, fasting, garment, and follow-up instructions with your team.
Will I have drains?
Some revisions use drains and others do not. If you have them, the team should show you how to care for them and explain when to call about changes in drainage.
When can I judge the result?
An early contour may be visible, but swelling and tissue settling can continue for months. Ask your surgeon when your particular repair can be assessed reliably.
06 · Safety
Risks and what your clinician assesses
Temporary soreness, bruising, swelling, tightness, and altered sensation can occur. Symptoms should generally improve; sudden, severe, or worsening changes need medical advice.
Bleeding or fluid collection
Blood or fluid can collect around the implant and may require drainage or another procedure.
Infection or wound problems
Infection, delayed healing, or skin breakdown may require antibiotics, wound treatment, or implant removal.
Recurring contour problems
A double bubble, low implant position, asymmetry, or other contour irregularity may persist or return.
Scarring, pain, or sensation changes
Scars can be noticeable, and changes in breast or nipple sensation or persistent pain may occur.
Implant and capsule complications
Capsular contracture, implant rupture, or further displacement may require treatment. Certain implants are also associated with rare cancers of the surrounding capsule; discuss your implant type and warning symptoms.
Anesthesia and blood clots
Anesthesia reactions and blood clots in the legs or lungs are uncommon but potentially serious surgical risks.
Discuss these risks and your individual health history with your surgeon. [2]
What your clinician assesses
- The location of the original fold, implant pocket, and extra crease
- Implant type, size, condition, placement, and surrounding capsule
- Skin quality, breast tissue coverage, sagging, and previous scars
- Overall health, nicotine exposure, healing risks, and expectations
07 · Costs
What makes up the Total Procedure & Care Cost
Compare written estimates for the same planned scope: fold or pocket repair, implant exchange or removal, and any lift or fat grafting. Different surgical plans can include different services.
Surgeon
Surgical care
The surgeon's work for the agreed revision procedures.
Ask your surgeonAsk which procedures are included and how additional treatment or later revision would be charged.
Facility
Anesthesia and facility
Anesthesia services and the operating and recovery facilities.
Ask your surgeonAsk whether these are separate bills and whether the estimate reflects the expected operating time.
Supplies
Supplies and follow-up
Potential implants, support materials, garments, medications, and postoperative visits.
Ask your surgeonAsk which items, imaging, and follow-up visits are included or billed separately.
TRC
Patient Services
Any separately listed planning, scheduling, or coordination services.
Ask TRCAsk whether a fee applies, what it covers, and whom to contact with billing questions.
Your written estimate should explain the services included, any separate charges, and payment terms.
08 · Questions
Common questions
Can this happen soon after augmentation?
Yes, it can become apparent early or develop later as tissues and implant position change. Early swelling can also obscure the cause. Your surgeon should assess the contour before deciding whether or when revision is appropriate.
Can correction use my existing scar?
Sometimes. The needed access and any planned lift determine incision placement. Additional scars may be necessary, and existing scars cannot be erased.
Will insurance cover correction?
Cosmetic contour revision is often not covered. Coverage for a related medical problem depends on your policy and documentation. Confirm benefits and authorization requirements directly with your insurer.
Can the double bubble come back?
Yes. Tissue weakness, implant weight, healing, or stretching of the repair can contribute to recurrence. Ask how your surgeon plans to address the underlying cause and what limitations remain.
0 consultation questions in your plan
View in My TRC workspaceMy Aesthetic Plan
Prepare for your consultation
Bring these to help your consultation:
- Understand the cause of the contour and the proposed repair.
- Confirm implant choices, expected limitations, and surgical risks.
- Have a written estimate, recovery plan, and contact instructions.
View My Aesthetic Plan
Choices stay in this visit until saving to your account completes. Nothing is sent to a clinician.
Sources
- [1]American Society of Plastic Surgeons: Breast Implant RevisionRevision goals, implant exchange, pocket adjustment, combined breast lifting, and the possibility of future implant surgery.
- [2]American Society of Plastic Surgeons: Breast Implant Revision Risks and SafetyRevision risks including bleeding, infection, healing problems, sensation changes, asymmetry, implant complications, anesthesia risks, and urgent cardiopulmonary symptoms.
- [3]American Society of Plastic Surgeons: Breast Implant Revision RecoveryIndividualized postoperative instructions, support garments, drains, follow-up, and gradual healing after revision.
Photographs are illustrative scenes, not patients, staff, facilities or outcomes. This information does not replace a personal assessment by your treating clinician.