#Double bubble serial

All patients were felt to be candidates for fat grafting treatment and desired correction of the deformity. Patients undergoing treatment demonstrated double-bubble deformities with symmetrically positioned breast implants. In this study, the author reports experience using fat grafting for treatment of the double-bubble deformity.

6 The advantage of fat grafting is the closed-nature of the grafting procedure as well as the quick recovery time and results which are difficult to duplicate with other techniques. 5 Recent reports have suggested that over 60% of plastic surgeons use fat grafting for reconstructive procedures, with over 20% using fat grafting as an adjunct to aesthetic breast surgery. However, in this study, they did not evaluate the preexisting double-bubble deformity and its treatment.įat transfer to the breast is used for a range of reconstructive and aesthetic procedures, including fat grafting for local contour irregularities 4 and volume enhancement. They reported good results and a high degree of patient satisfaction for primary fat grafting at the time of breast augmentation. Recently, Serra-Renom et al 3 reported the use of fat grafting the inframammary crease at the time of subfascial breast augmentation for patients with tuberous breast deformity. Although plastic surgeons routinely fat graft breasts for a variety of reasons, little is known about the efficacy of fat grafting to reconstruct the double-bubble deformity. Strategies for repair of the double-bubble deformity include reconstruction of the inframammary crease by capsulorrhaphy, scoring of the breast parenchyma to reduce the difference in tissue thickness above and below the crease, 1, 2 and other treatments. The appearance of this deformity is due to the presence of breast parenchyma above the original crease, and thinner subcutaneous tissue without breast tissue below the crease.

Because of short nipple/fold distances often seen in patients desiring breast augmentation or asymmetric inframammary folds, the double-bubble may occur when positioning an implant in the appropriate position. It can occur when a breast implant is positioned below the old crease at surgery or when an implant falls below the crease with the passage of time creating a contour deformity. The double-bubble deformity occurs when a breast implant sits lower than the old inframammary crease. The procedure allows the correction of a challenging deformity with a simple, closed technique which is safe and cost-effective. This study suggests that fat grafting is an effective treatment of the breast double-bubble deformity. All patients were pleased with the results of treatment, and no revisional surgery was required. Twelve patients with limited breast tissue underwent magnetic resonance imaging examination at the conclusion of the fat grafting sessions, and no implant injury or disruption was noted. There were no oil cysts, infections, or donor site problems noted in the series.

Fat was injected with a 1.5-mm blunt cannula into the subdermal and superficial breast tissue layers beneath the old inframammary fold. An average of 27 cm 3 of fat was injected with each treatment per breast. Up to 3 sessions of fat grafting were performed on each patient, with a mean of 2.1 sessions required for patients in the series. Eight patients presented with bilateral double-bubble deformity. Fifteen patients had undergone primary augmentation, whereas 13 patients had undergone augmentation mastopexy.

Twenty-eight patients with double-bubble deformities were retrospectively evaluated.

#Double bubble serial

In this study, the author reports experience with a simple, closed technique of serial fat grafting procedures to treat the double-bubble deformity.

Classically, open techniques have been used to treat this deformity, including elevation and reconstruction of the inframammary crease or parenchymal scoring. The double-bubble deformity is one of the most common problems in breast augmentation, with or without mastopexy.