Lowering Breast Crease After Augmentation?

what complications can occur for lowering a breast crease and a periareolar mastopexy on one breast so that it is symmetrical with the other breast...is it possible to lower a breast crease after breast augmentation?

Doctor Answers (8)

Lowering a breast crease, breast fold asymmetry treatment with implant augmentation or enlargement

+2

SEE VIDEO FOR BREAST ASYMMETRY:

The difficulty in lowering a crease is achieving a precise new level despite meticulous intraoperative technique. Typically surgeons will undercorrect intraoperatively to allow for descent over time and to minimize the potential to "bottom out". The risk of lowering a crease are essentially undercorrection or overcorrection.

I typically advise patients to wear a cutout underwire bra for at least 6weeks 24x7 to support and maintain the newly created crease.

To review two patients on whom this was performed fast forward to 1min50sec and 2min to see samples of lowering the crease.


Chicago Plastic Surgeon
5.0 out of 5 stars 48 reviews

Breast crease can be lowered after augmentation

+1

Yes, you can just lower the breast crease. Be sure you get a great informed consent so you fully understand the risk/benefit ratios. Regards and Good Luck!

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 64 reviews

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Lowering the breast crease for breast asymmetry

+1

Most breasts are slightly asymmetric and require a small (or sometimes more dramatic) surgical adjustment. It is often common for us, as surgeons, to use two different approaches to help make your breasts appear more symmetric in the end. Thus, the planned approach to both lower the fold and lift the nipple (periareolar mastopexy) is likely based on your surgeon's exam and your preexisting differences.

My concern with multiple simultaneous surgical procedures, is that the process becomes more complicated when there are an increasing number of adjustments being made. Women can have a "constricted breast," or just a high or asymmetric fold that needs to be adjusted to match the other side. We, however, must be very careful with the adjustment of the breast fold, as this is the "floor" of the breast that prevents an implant from "bottoming out." This can make the breast look unnatural and unattractive if the implant has descended below the natural crease of the breast. Thus, smaller adjustments are usually more successful. And, if a big change is needed, more reconstructive techniques need to be employed.

Make sure that you understand your surgeon's concerns and goals to make sure they match your own.

Best of luck.

Vincent P. Marin, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 26 reviews

Lowering breast crease after augmentation

+1

If there is asymmetry in breast crease height after augmentation it is possible to go back and lower the crease. The key is to avoid lowering it too much which could result in that side now being lower than the good side. I would be sure to wait at least 6 months after augmentation before proceeding because I have seen many implants start out too high and slowly drop on their own.

Robert B. Pollack, MD
La Jolla Plastic Surgeon
5.0 out of 5 stars 14 reviews

Lowering a breast crease is possible through a peri-areolar approach

+1

The primary complication for the combination of procedures that you describe is

'post operative asymmetry'

For primary augmentations that don't involve a combo with mastopexy (breast lift), the infra-mammary fold (breast crease) is frequently lowered to obtain symmetry with the opposite breast, or make the distance from the fold to the nipple longer to accommodate a specific implant.

The infra-mammary crease is a definite anatomic structure, and when it is 'lowered', it must be properly reconstructed in order to prevent 'bottoming out', which is when an implant descends down the chest wall below the infra-mammary crease.

It is technically possible to lower an infra-mammary fold during a combined breast augmentation and breast lift. However, there are a lot of 'moving parts' for this particular combo operation. Hopefully, your surgeon has informed you that the surgical revision rate for combined mastopexy and augmentation has been recently reported to be close to 50%.

One operation (combo pexy and augmentation) certainly is more convenient than two separate procedures (mastopexy, followed by augmentation a couple of months later). But the 'staged' approach is probably more predictable. If your surgeon was honest with you, he/she would have explained this concept in detail.

Take a look at lots of post-op photos and get plenty of opinions from local surgeons before you book your procedure.

Scott C. Sattler, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 39 reviews

Lowering breast crease can help with breast asymmetry and breast augmentation.

+1

Hi.

Really hard to give you specific advice without examining you. We use lowering of the breast crease often in breast augmentation.  Like anything else, it has to be done just right. But in general it is safe.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

The breast crease can be lowered during an augmentation

+1

Hi DanielleC1982 - Yes, the breast crease can be lowered during an augmentation to make the breasts more symmetric. This can involve an incision along the breast crease followed by lifting of the skin to lower the fold and then placement of an implant. One complication that can occur is that the crease is lowered too much. Good luck!

Jeffrey E. Schreiber, MD, FACS
Baltimore Plastic Surgeon
5.0 out of 5 stars 77 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.