Hi. It's been suggested my IMF is very low, and that raising the fold could improve my shape. Is this the same thing as a lift? I would love to have a fuller, rounder shape, more circular. I feel like my breasts are long and I have no cleavage. The right almost looks like a v shape. I have very small high profile saline implants and I wonder if they should be filled more to improve the shape and fullness as well? Thanks so much for your suggestions! This will help me when I go back to see my PS
Is Raising my Low IMF the Same As a Breast Lift? (photo)
Doctor Answers (13)
Raising the IMF Same Thing as a Breast Lift?
Raising a low IMF is definitely not the same thing as a breast lift. Your before photos indicate that your implants had bottomed out and the fold was pushed down too low. Raising and reinforcing the IMF was the appropriate correction, however your after photo was taken from a different angle so it is hard to tell how well the problem has been corrected. You are still quite early after surgery and things will still settle in with additional changes to your breast shape. Adding more fill to your implants is unlikely to give you greater cleavage. Creating more cleavage is not something that can always be fully achieved with an implant.
Raising the IMF
Raising the IMF has been a great technique for tightening up the breast. It is unclear if you are showing before and after photos, and what the right photo represents. The photos on the left seem to indicate that lifting the IMF would be a very good way to go. The space around the breast implant is too large so it needs to be tightened up. It's possible that may require some internal tightening sutures as well at the time of surgery. More often than not, if you want more volume, then you need to change the implant entirely rather than fill up the one you have. Typically you cannot add enough to make much of a difference.
Not the same thing
No raising your inframammary folds is not the same thing as a lift. Your pre-operative photos show a classic indication that your implants have "bottomed out". Your early post operative results seem to show that the reconstruction to your inframammary folds was successful.
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A Breast Lift VS. Raising the Infamammary Fold
The inframamary fold (IMF) is a discrete anatomical structure where the chest ends and the breast begins. It is a dense attachment of the breast skin to the chest cage. Certain breast operations intentionally disrupt the IMF to place a large implant (rarely a really god idea) or perform a mastectomy ( again not a good idea as it makes breast reconstruction much harder). A sharp, crisp curved IMF is crucial in creating an attractive breast and there are several methods to create it.
A Breast Lift refers to several operations which remove excess skin from the lower half of the breast to push the breast contents upwards and reposition a sagging nipple complex to the center of the breast mound creating an attractive round breast with a centrally located nipple.
In your case you appar to have had way too much surgery. It is hard to tell when your IMF was destroyed during your (? Overly done) Breast reduction which was then followed by an attempt to add volume to the breast by the placement of large breast implants. These in turn, expanded the lower pole of the breasts further weakening the IMF and resulted in implant descent and "Srar Gazing" nipples. Your (last) surgeon corrected your implant positions by using Strattice stitched to the rib cage holding up the implants thereby recreating the IMF's. You have a nice result considering where your surgeon started from. I would stop here and not have any more operations. Ths s a clear example where"Better is the enemy of Good".
Thanks for your question. I believe your revision with Stattice really improved your shape. I am not sure what your final expectations are, but you are still early with changes to come.
Is Raising my Low IMF the Same As a Breast Lift?
Raising a low inframammary crease to treat the problem of inferior implant displacement or "drop out" is what you had done, and this is not the same as a breast lift. Breast lifts are used to treat a breast that is hanging too far OVER the inframammary crease and/or a nipple that is hanging below the level of the crease, and the lift is done to lift the nipple and the breast tissue IN RELATION to the crease. You do not have any overhang, and your nipples are not too low. Therefore, you do not need a breast lift. You may benefit at some point from scar revisions around the nipple area, etc., but for now you have had a good correction of "drop out", and this is an extremely difficult problem to correct and to keep from recurring...the Strattice is helping to maintain the strength of your repair. I would make sure that things heal well and settle down for at least 6 months, and maybe as long as a year, before you start to pursue other implants, etc. Your breasts will continue to change in shape, so do not be impatient.
Low breast fold after breast lift
The low breast fold is more to do with the bottomed out breast implant with the point of projection well below the nipple. It appears that the repair has gone well raising and centering the implant within the breast. It is possible to change the implant profile or base diameter to adjust the fill, though you have just been through a difficult situation. Wait a bit until the result is stable and well healed.
Best of luck, peterejohnsonmd.com
Breast Augmentation/Mastopexy Revision Concerns?
Thank you for the question and pictures.
It seems like you have had a good repair of the bottoming out of the breast implants. I would suggest that you wait an additional 6 months before evaluating the end results of surgery. Once the repair is solid then use of different size/profiles of breast implants may be considered to improve fullness/cleavage concerns.
Raising the lower breast fold (IMF) and mastopexy
The inframammary fold, the area underneath the breast, is called the IMF. In reviewing your first two photos, it appears as if you have what is commonly described as bottoming out. To answer your question: Yes, raising your IMF is considered a mastopexy. It is only one component of a mastopexy procedure, however. It may be that you need some elevation of the IMF, tightening of the lower pole skin, and elevation of implant position in order to create more upper pole fullness, centralize the nipple position and create a more beautiful shape. In the 3rd photo, most of the problems appear to have been corrected. The right lower pole, however, still appears slightly more full compared to the left side, and the nipple is oriented more upward. The left side may settle in the next several weeks because you are still in the early post operative period. I do not believe that increasing the volume in your implants will correct these asymmetries.
Implant plication is NOT a mastopexy
Your photographs show that the implants have descended inferiorly and are bottoming out. The capsule for the implant needs to be plicated inferiorly to give you a lift or smaller implants placed. A mastopexy is an operation that lifts the breast tissue NOT the capsule of an implant. If you would like your shape and fullness improved, you will need a mastopexy through a peri-areola incision. It would move your own breast tissue more medial and up as well as your nipple. This can be done avoiding the vertical scars or the boat anchor incisions.
Best of Luck,
Gary Horndeski, M.D.
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