Breast augmentation is a life-changing procedure for many women, offering enhanced aesthetics and renewed confidence. However, complications such as double bubble and symmastia can sometimes arise, affecting the appearance of the breasts. These conditions, though concerning, are treatable with the right expertise and surgical intervention.

In this article, we’ll explore what double bubble and symmastia are, why they occur, and the innovative techniques that can correct these conditions to restore a natural, beautiful appearance.

What is Double Bubble?
A double bubble deformity occurs when the breast implant descends below the natural inframammary fold (the crease where the breast meets the chest). This creates a visible crease or line across the lower portion of the breast, resulting in an unnatural two-fold appearance—hence the term “double bubble.”

Symptoms of Double Bubble:

• The breast takes on a dual contour, with one curve at the top and another curve or indentation below.
• The natural inframammary fold is more prominent and sits higher than the bottom of the implant.
• The breast appears droopy or uneven, especially when compared to the opposite breast.

Causes of Double Bubble:

1. Breast Implant Placement Below the Fold:
    The most common cause of double bubble deformity is incorrect implant placement, where the implant slips beneath the inframammary fold and into the breast tissue.
2. Breast Tissue Characteristics:
    Women with sagging or excess breast tissue can be more susceptible to this complication, especially if the implant is not properly supported.
3. Overly Large Implants:
    Implants that are too large for the natural anatomy of the breast can stretch the tissue and lead to displacement, contributing to the double bubble effect.
4. Natural Anatomy and Muscle Structure:
    Some women’s anatomy, such as a high-riding inframammary fold or tight skin, can increase the risk of this complication.

What is Symmastia?
Symmastia, also referred to as “bread loafing” or “uniboob,” occurs when the breast implants merge together across the chest, eliminating the natural separation between the breasts. The condition often gives the appearance of a single breast or causes the skin between the breasts to lift unnaturally.

Symptoms of Symmastia:

• The breasts appear joined together, with no clear separation between them.
• The skin between the breasts may feel tight or raised.
• There may be discomfort or unusual tension across the chest.

Causes of Symmastia:

1. Overly Aggressive Implant Placement:
    Symmastia is most commonly caused by implants being placed too close to the midline of the chest. This can result from overly aggressive dissection of the tissue during surgery, causing the implants to shift inward.
2. Implant Size:
    Large implants, particularly when placed in a narrow chest, can lead to symmastia by pushing the skin and tissue together, eliminating the cleavage.
3. Weak Chest Tissue:
    Patients with naturally weak or thin breast tissue are more prone to symmastia, as the tissue may not provide enough support to keep the implants properly positioned.

Solutions for Correcting Double Bubble and Symmastia
Both double bubble and symmastia are treatable with surgical revision. Each condition requires a highly individualized approach to correct the deformity and restore a natural, symmetrical appearance. Here’s how they can be corrected:

Correction of Double Bubble:

1. Internal Bra Technique:
   Dr. Don R. Revis, JR., MD, FACS, has pioneered the Original Internal Bra technique to address complications like double bubble. This innovative procedure uses biologic or synthetic materials to create an internal support structure for the implants, preventing them from slipping below the natural fold and maintaining their proper position. This method also strengthens the tissue and reduces the likelihood of future complications.
2. Repositioning the Implant:
   In some cases, the implant can be repositioned higher within the breast pocket to correct the double bubble deformity. This involves revising the existing pocket or creating a new one at a more anatomically appropriate level.
3. Pocket Modification:
   Tightening or adjusting the lower portion of the breast pocket can help prevent the implant from slipping below the inframammary fold. The pocket may be reinforced with sutures to hold the implant securely in place.
4. Switching Implant Placement:
   If the original implant was placed above the muscle, revision surgery may involve placing the implant below the muscle (submuscular placement), providing greater support and a more natural contour.

Correction of Symmastia:

1. Internal Bra or Reinforcement with Mesh:
   For patients with symmastia, Dr. Revis often employs the Internal Bra technique using surgical mesh or biologic grafts. These materials act as an internal scaffold to keep the implants separated and provide additional support to prevent them from shifting inward. This technique is particularly effective in patients with weak tissue.
2. Capsulorrhaphy:
   In cases where the breast implant pocket has been over-dissected, capsulorrhaphy—a surgical procedure that involves suturing the implant pocket—can help reposition the implants and restore the natural breast separation. The sutures prevent the implants from migrating inward, maintaining a more aesthetically pleasing cleavage.
3. Implant Size Adjustment:
   For patients whose symmastia is caused by overly large implants, selecting a smaller implant that better fits the chest wall can alleviate tension on the skin and tissue. This adjustment helps restore the natural spacing between the breasts.
4. Switching Implant Placement:
   Similar to double bubble correction, moving the implant to a submuscular position can help prevent the implants from shifting inward and ensure better support.

Why Choose Dr. Don R. Revis, JR., MD, FACS?
With decades of experience and a reputation for surgical excellence, Dr. Don R. Revis, JR., MD, FACS, has become a trusted name for breast augmentation and revision surgeries. As the creator of the Original Internal Bra, Dr. Revis offers cutting-edge solutions for complex breast surgery complications such as double bubble and symmastia. His personalized approach ensures that each patient receives the care, attention, and expertise needed to achieve optimal results.

Whether you are experiencing issues with a prior breast augmentation or simply want to explore the best options for your revision surgery, Dr. Revis can help restore both your appearance and your confidence.

Get the Perfect Look You Deserve
If you are struggling with complications like double bubble or symmastia, don’t wait to explore your options. Schedule your free virtual consultation today with Dr. Revis, the innovator behind the Original Internal Bra, and let us help you achieve the beautiful, natural-looking results you’ve always envisioned.

Trust your transformation to the hands of a true expert.