Why and how do surgeons create new inframammary folds in the breast?

Question

how does a surgeon decide if he needs to create this new fold? is it because the breast sit too low on the chest? how do they create the new fold?

Shlomo Widder, MD · Answer

Hello again Mariie,    It is not necessary in every breasts augmentation surgery to create a new infra mammary fold. If the distance between the IMF and the nipple is 7 - 9 cm, there is no need for new fold because there is enough room even for  large implants. When  the distance is short , it is necessary to lower crease ( IMF ) to create room for the implants and in case of mild ptosis ( saggyness ) , give a lift to the nipples. It is easier and more natural to create the new IMF through a subareola incision that allows better visualization and control of the area.  Always, consult with experienced board certified plastic surgeons. Check their before and after pictures to make sure that they are numerous, consistent and you like the results.                  Best of luck,                                         Dr Widder

Ryan Neinstein, MD, FRCSC · Answer

A loaded question but basically the size of an implant will dictate how far the nipple should ideally be from the fold and if it is not that distance an incision lower down on the chest would likely be used to accomodate for the size of the implants

Curtis Wong, MD · Answer

will vary from when the implant exceeds the patient's natural base width to elevating an implant and reconstructing the fold at a higher point.  But its done routinely, depending on what the problem is.

Steven Wallach, MD · Answer

I do not usually undermine the breast fold to place breast implants, but on occasion especially with a constricted lower pole, I am forced to do so.

Robert Whitfield, MD · Answer

You need to be careful about manipulating this structure.  Skin quality, breast tissue, skin laxity, and the implant size will all play a role in maintaining the position of this structure in augmentation.In breast augmentation I have chosen to spend time reviewing
photographs with patients to fully understand their expectation of size and
shape.  Many times this simply raises
more questions.  I will make measurements
and use the implant guides to allow the patient to understand exactly the sizes
that are reasonable for their body type and measurements.

Please find an experienced Board Certified Plastic Surgeon
and member of the Aesthetic Society using the Smart Beauty Guide.  These Plastic Surgeons can guide you on all
aspects of facial surgery, breast augmentation and body procedures including
tummy tucks or mommy makeovers!

Brooke R. Seckel, MD, FACS (retired) · Answer

Most plastic surgeons are very careful not to violate or damage the inframammary fold when doing breast augmentation.When an implant has bottomed out or in cases of breast reconstruction after mastectomy the most common procedure to create an inframammary fold is called the internal Ryan procedure.  During this procedure the surgeon uses sutures to stitch the breast fold to the periosteum of the rib to establish a new crease beneath the breast.  In cases where a breast implant capsule is present the capsular tissue can be pexied or tightened any new fold created from inside.

Why and how do surgeons create new inframammary folds in the breast?

Answers (6)

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