Can massage correct the problem with my new implants? (Photo)

Question

I had a biplanar augmentation done in February this year. We chose to use 550cc Ultra High gel implants. I went from a size 36B to 36DD. However, after the implant settled On my left side it developed this crease (as shown). I noticed it coming up after I started lifting and going back to work. I also wonder if I have maybe pushed it too far down? I spoke with a nurse this week who suggests massaging the crease hoping that the crease is from memory in the old breast. Is it possible?

G. Robert Meger, MD · Answer

NikkiAnn:  What you are seeing is a retained infra mammary fold, or where the crease between your breast and chest wall USED to be.  We do see this from time to time and in most instances it resolves on its own, and usually within 6 months.  In your case, your surgery has been long enough ago that I don't expect this to resolve without further surgery.  The lower portion of the pocket the implant sits in needs to be partially closed.  There are a few options available to perform this technique which you should discuss with your surgeon.Best of luck to you!G. Robert Meger MD

Andrew Wolfe, MD · Answer

Thank you for your question.  What you are seeing in both breasts is the remnant of the old inframammary fold.  You were a bit relaxed prior to your augmentation, and the implant has settled down below the level of the original fold.  (It's unlikely that this is due to anything you did.)  As a result, you can see where the actual breast tissue ends and the implant begins.  This demarcation may settle with time and become less noticeable, but it may not.  If you end up with more of a depression there than you want, a procedure to reestablish the inframammary fold (capsulorrhaphy) may be beneficial.  Talk to your surgeon to get a sense of timing, expectation, etc.

Michael J. Brown, MD · Answer

Hi,

Thanks for posting your question. I am happy to try and help you. It is
important to remember that a board certified plastic surgeon will be your best
resource when it comes to an accurate assessment of your situation, and
concerns.

Having said that, your pictures do demonstrated that you have had your breast
implant settle below the breast fold. You also had low nipples before surgery. So what you are seeing is the new lower
breast fold is where the breast implant has settled to and the crease on the
breast is actually the old fold or old crease of the breast. This occurs
because of a few different factors and in any situation, not every person who
gets a double bubble is getting because of the same reasons.

So here goes the most common causes, and remember your double may be because of
only one of these or some combination a few of them. Each and every case is
different. The repair is possible regardless of the cause(s). The type of
repair will be different based upon what or how the double bubble occurred.

sharp, well developed tight fold
     (IMF = inframammary fold)short distance from 6 o'clock
     position of areola and presurgical IMFtight strong tissues of the IMF
     inadequately released at surgerytoo large of a breast implant for
     the dimensions of the chest and breasttoo heavy of a breast implant for
     the tissues of the breast to supportlower pole fallout

So the repair of the double bubble consists of rebuilding the fold, it is
called IMF reconstruction and there are many methods to do this. It is best to
see a plastic surgeon with experience IMF recons to assist you with this. It
will require surgery. In the meantime, wear support.As for your breast, you probably should have considered a breast lift.

Best wishes,

Dr. Michael J. Brown
Northern Virginia Plastic Surgeon

Sugene Kim, MD, FACS · Answer

Hi,MissNikkiAnn.  Thanks for your question and photos.  Your crease line is from your old inframammary crease; you seem to have a double bubble.  The double bubble may stabilize or get worse with time.  Massaging will not help with the crease line.  Please talk with your plastic surgeon if you want it to be corrected.  Best regards.

Jeffrey Zwiren, MD · Answer

The crease that you are noticing on the left side is also known as a double bubble.  Your crease may be due to the adherence of the transected inferior portion of the muscle adhering to the capsule.  This combined with some bottoming out and stretching of the inferior pole of the breast is the primary problem.  Massage will be of no benefit for correction you will need additional surgery.  I would recommend discussing  your concerns with your plastic surgeon.

Stephen M. Davis, MD, FACS · Answer

Unfortunately the crease you are seeing is probably to old infra-mammary fold. I do not believe that massage will be of much benefit. I would let you Board Certified Plastic Surgeon evaluate this and I am certain he / she will help you.Good LuckStephen M. Davis, MD, FACSGreen Hills Plastic Surgery

Lisa M. DiFrancesco, MD · Answer

Thank you for your question. A crease in the lower pole of the breast is often from the old inframammary fold and the implants has settled below the old fold. An examination and consult is needed to determine the correct treatment.

Darryl J. Blinski, MD · Answer

No, only revision surgery might help. But only in person examination would allow a definitive response...

James E. Leake, MD (retired) · Answer

that crease on your left side will not improve with massage. it looks like the old inframammary crease. this is creating a so called double bubble. this will need surgical correction.

Can massage correct the problem with my new implants? (Photo)

Answers (9)

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