Double-bubble deformity in breast augmentation: correction with percutaneous barbed sutures

The double-bubble deformity is a complication after breast augmentation that often requires additional treatment such as elevation and restoration of the inframammary fold (IMF), parenchymal scoring or fat grafting. We describe a percutaneous technique that combines dual plane pocket dissection, parenchymal scoring and placement of a percutaneous barbed suture to create a new IMF. This technique takes approximately 10 minutes per breast to complete, and the resulting breast has an immediately noticeable double-bubble free surface. This technique can both prevent and treat a double-bubble deformity after dual plane breast augmentation. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .