![]() ![]() ![]() 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. 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. ![]()
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