PRSonally Speaking

Wednesday, October 30, 2013

Articles of Interest Sneak Peak: The Double Bubble Deformity: Etiology, Prevention and Treatment
At least twice a month, PRSonally Speaking posts full abstracts of interesting or potentially controversial articles from a future issue. This 'sneak preview' of a hot article is meant to give you some food for thought and provide you with topic for conversation among colleagues.
When the article is published in print with the December issue, it will be FREE for a period of Two Months, to help the conversation continue in the PRS community and beyond. So read the abstract, join the conversation and spread the word.
This week we present the introduction to "The Double Bubble Deformity: Etiology, Prevention and Treatment" by Handel et al.

Background: The "double bubble" is a widely recognized complication of breast augmentation but there have been very few articles in the peer-reviewed literature devoted exclusively to this topic.

Methods: Prior publications addressing the anatomy of the inframammary fold (IMF) and its relationship to the double bubble deformity are systematically reviewed. Disagreements among authorities regarding the precise anatomical structure of the IMF are addressed. The etiology and surgical correction of the double bubble are discussed in detail as they relate to the anatomy of the fold.

Results: The key to understanding the causes and correction of the double bubble lies in an appreciation of the anatomy of the IMF. Correction of the deformity varies depending on whether or not patients had pre existing anatomical features predisposing them to development of a double bubble.

Conclusions: A variety of surgical strategies, including use of a dual plane pocket, form stable shaped implants, capsulorrhaphy, pocket plane conversion and use of acellular dermal matrices can play a role in prevention and treatment of the double bubble deformity.
In a type III dual plane pocket, the origins of the pectoralis muscle are divided across the inframammary fold and the retromammary plane is dissected to the superior border of the areola.
The full article will be published with the December 2013 issue of PRS, and will be free online for non-subscribers. Until then, we hope this "sneak peek" will pique your interests and start a healthy, meaningful conversation.