Breast Implants: Q&A

Ask a Question

Breast Aug Scar is a Few Inches Above the Fold Line - is This a Mistake?

Is it common to have a breast augmentation scar one and half inches above the breast fold line? Or are most incisions right on the fold line? Did the doctor make a mistake if the scar is not on the fold line?

Tags:

Comment on this

21 Doctor Answers | Asked by Eva S in Seattle, WA

Doctor Answers (21)
Community Comments (0)

Position of Implant Incision

The implant incision is usually planned to end up about 1/4-inch above the crease. The final position is influenced by the tightness of the skin in relation to the size of the implant. Even if the incision seems high right now, as the skin relaxes during the weeks after surgery, the position may end up closer to the crease. Please do tell your surgeon about your concerns.

The breast aug incision should be nearer to the fold line

Ideally the incision should be exactly in the fold or just barely up onto the lower pole of the breast. It is possible that your implants have descended ("bottomed out") to where the incision has ridden up. This is especially possible with bigger implants and with saline implants whose capsule is often very thin.

Breast augmentation scars

Dear Patient, Generally, scars should be as close as possible to the fold, unless some type of breast lift procedure was performed. Also, the fold could have been lowered during surgery to improve the overall esthetic look.

Breast augmentation scar

For our breast augmentation patients in Michigan, we often place the incision above the breast fold. This will allow you to wear a bikini, and if the bathing suit rides up your incisions will still be hidden. Also, the incision is often underneath the natural curve of the underside of the breast that way as so less visible.

Inframammary scar ideally ends up in the fold.

When planning the inframammary incision, it is important that your plastic surgeon takes several factors into the planning. The scar will ascend from a few millimeters to a couple of centimeters after surgery. The implant takes up some of the slack in the skin which pulls the upper abdomen up towards the breast. The implant can lower the fold beneath the breast a little as well. A well designed incision takes these factors into the equation to give the scar the best... more

Location of inframammary scar

It is not necessarily common to have a scar one and a half inches above the fold. However, most incisions do not always end up right in the fold. There usually is some migration of the scar above the fold even if the initial incision is placed below or in the original fold line. Some of that migration is difficult to predict although the size of the implant does influence final scar location. When an implant is placed in the breast, the previous amount of skin in... more

You want the incision on the breast.

You want the incision on the breast. An incision 1.5 inches above the fold is a little high, but a little high is better than a little low. As long as the incision is on the breast it will be covered by most swimsuits or bras. If it is too low then it could become more visible. The incision is usually placed near your original fold -- and most folds are lowered as part of the surgery. (The larger your breast becomes the lower the fold has to go). Each patient... more

Fold incision for a breast augmentation

To have the incision an inch and a half is a bit high. It is common to have the incision at or just above the fold as this hides the incision well. If the implants are very large or the fold is "lowered" then the incision can rise up if the implants "bottom out." I recommend following up with your plastic surgeon for there are procedures which can correct bottoming out.

David Bogue, MD

6 reviews

Boca Raton Plastic Surgeon

www.drbogue.com

Breast augmentation scars - getting them to stay in the fold

Hello. What you describe is not uncommon. It can be due to various factors, including the way the surgery was planned, the migration of the implant below the original incision line, stretching of the skin at the fold etc. If the scar is slightly above the fold, it will usually fade over time and not be very visible. If the scar rises well above the fold and is very obvious, this can be addressed by trying to reduce the color and thickness of the scar, using lasers or intense... more

Your incision is not a mistake

Your situation is not uncommon, and unlikely a mistake. Depending on the size of your breasts, as well as the size of your implants, the crease below your breasts may have moved downward after the incision was made and the breast implants placed. While surgeons performing breast augmentation do their best to anticipate where the new fold will lie, the concern for making the incision too low is that it rests on your chest below your breast- this is an area where it can be more easily seen... more

An inframmary incision for a breast augmentation should be right in the fold.

Your incision is too high (or your fold is too low) and your surgeon would probably agree. Although this is not ideal, most breast incisions that are not in the crease end up being practically invisible in time. If the scar is really in the wrong place, it can be revised but not really moved. Probably best to leave it alone.

Migrating imfamammary scar position

Breast augmentation is the most common cosmetic surgery in the United States because it provides a consistent way for a woman to change the shape, position and size of her breasts. There are many different positions for the scar for a breast augmentation. Placing the scar at the crease of the breast may be beneficial in women who already have a very well-defined crease at this site. However, the disadvantage of this scar is what you are experiencing. The breast will change shape and... more

This is a matter of opinion

Hello, I know of surgeons who put their incisions in different locations than I put mine. They have their own reasons. You might want to discuss this with your surgeon.

This is a complication and it can be corrected

To Tara, Hi. Complications happen to the best of surgeons, and I have certainly seen this problem (very rarely, fortunately). It does not mean that your surgeon did anything wrong. The good news is this can be corrected with a "capsulorrhaphy," which means raising the implants with a row of internal stitches, so the scar ends up at or just above the fold.

Learn from your mistakes?

Tara, The practice of plastic surgery is not an exact science. There are many variables that can affect the position of a scar after breast augmentation, some of which the surgeon has no control over. Your implant may have descended due to gravity causing the incision to ride up slightly on the breast. If this is the case sometimes the implant needs to be repositioned and the fold recreated with sutures.

This is a common but unnecessary scar location

Most surgeons make the inframammary fold incision on the fold. This is often how it is taught in residency. However, when the implant is placed the lower breast and fold skin is then pulled up onto the breast, as in your case. I recognized this early on and make the incision 1cm below the fold. When the implant is placed the incision and thus future scar are pulled up to the fold. The good thing is that breast scars tend to fade well with time and are usually relatively inconspicuous. more

Inframammary scar placement

The goal is to provide as inconspicuous scar as possible. I try to place the scar in the fold where I feel it is best hidden. The way a woman's body will heal cannot be fully predicted and there are times that the lower breast skin and tissue will stretch allowing the incision come up a little on the lower breat mound. If the incision is more than 2cm above the fold however, your implant may have dropped out. This is more of a possibility with larger implants in women with thin tissues. I... more

Incision line for breast augmentation

Incision location varies. Usually it is ends up just at or just above the fold. However, in some cases the incision can migrate up a bit especially if large implants are placed or if there is bottoming out. Remember a scar too low can slip out of the bikini and be somewhat embarassing.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

The incision should be closer to the fold

In general, we want to have the incision just above the fold. If the incision is right in the fold, it can be painful or obvious. If you wear a bikini, it is common for the bottom to ride up a small amount on the breast. We don't want anyone to be able to see your scar, so we raise the scar by about 1 cm, or 1/3 of an inch. If the scar is up more than an inch, you may have bottomed out your implant and your fold on the bottom of the breast may be abnormal. Contact your plastic surgeon to... more

Unfortunately, this happens

Often even though the surgeon places the incision exactly where it belongs the tissue stretches in somewhat unexpected ways. As this occurs and the implants descend somewhat on the chest wall, the incision can end up higher than the ideal desired place in or just above the crease. Of course it also could have simply been made too high on the breast but this is unlikely when the surgery is done by a well trained, board certified plastic surgeon.

It is possible and can be normal.

In my practice, this typically happens in women who start off with a fairly small cup size and add a large implant. A patient's chest wall is designed for only so large an implant, but most women I have encountered routinely go larger than their normal dimensions will allow. When your surgeon marked you before your augmentation, he/she probably marked the incision right in your breast fold. If the implant was large, the pocket would descend below this margin causing the incision to... more