Does a short nipple to inframammary fold length limit the size of my implant (without lowering my fold)? (Photo)

There needs to be a certain distance from the nipple to the inframammary fold (IMF) for a breast to look normal.  The larger the implant, the larger that distance needs to be.  There are multiple measurement systems that allow surgeons to determine where the IMF needs to be based on an implant's dimensions (I personally use the one developed by Dr. Charles Randquist in Stockholm, Sweden). Other factors like tissue stretch need to be factored in as well.Based on your photos, it looks like your inframammary incisions will need to be set lower than your natural folds in order to avoid high-riding implants with low set nipples.  Once you are measured, you can select an implant that is large enough to make you happy, but also fits your chest base width diameter.  Once the implant size / style / profile is selected, your surgeon should be able to precisely know where to place your incision to achieve the ideal nipple to fold distance.  With tighter tissues, it may take longer for the implants to settle, but the incision needs to be placed at the right position at the time of surgery.  You should likely be able to get in the size range you want, but choosing a somewhat more modest sized implant will reduce the amount your IMF will need to be lowered and, to some degree, will reduce the chance of complications. Hope that helps!

Having a short inframmary fold to nipple distance is fairly common.  The larger the implant, the longer the arc from nipple to inframammary fold distance is required to center your implant behind your nipple.  If your fold is not lowered with a large implant, the majority of your implant will sit above your nipple position.  With a small implant, minimal inframammary fold manipulation is required.  With a large implant, the fold will need to be lowered to accommodate the implant, increasing your long term risk of bottoming out.

Thank you for sharing your question.  If your implant is not large, your breast skin will stretch and create a more natural breast appearance over time.  If a large implant is desired, you would need to lower your fold or stage your augmentation over two operations.  Hope this helps.

Hello and thank you for your question. You are a great candidate
for a breast augmentation.   The fold can be lowered.   The size, profile, and shape of the
implant is based on your desired breast size/shape, your chest wall
measurements, and soft tissue quality.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.  This entire surgery
can be performed with a small incision technique.  Make sure you
specifically look at before and after pictures of real patients who have
had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a
surgeon you are comfortable with. I recommend that you seek consultation with a
qualified board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

From my experience, it would be best to lower the fold to 7-8cm below the nipple. The nipple should ideally sit in the middle of the breast, so as a rough guide, the distance from the nipple to the inner and outer and lower border should be the same. So if your breast width is 14cm as an example, the fold should be about 7cm below the nipple.

Another factor to consider is the projection of the implant. Implants with the same footprint (=height and width) can have different volumes and projections. That also means that implants with different volumes can have different footprints and hence different requirements for the level of the inframammary fold.

In your case I guess from the photos that you would be able to get good results if you are aiming for a C cup size.

There is no question your fold will need to be lowered significantly. The normal distance from the nipple to fold in a well proportioned pretty breast of C-D cup size will be 9-11 cm. If the fold is not lowered adequately you will be top heavy and look artificial and fake, and have a very "augmented" look rather than a pretty well proportioned natural looking breast. Make sure you discuss your size and fold concerns thoroughly with your plastic surgeon, and be sure that your aesthetics align with your surgeon's. Good luck.

Yes, a shorter distance from the nipple to the fold, and the overall measurements of your breasts in general, help to determine the size limit of your implants. After I examine and measure my patients, we look at before and after photos of my patients who are similar to them in height, weight, frame, and starting volumes to assist them in determining what they desire. Your surgeon should be able to assist you in determining your goal and what size is possible for you. Good luck. For more information on this and similar topics, I recommend a plastic surgery Q&A book like "The Scoop On Breasts: A Plastic Surgeon Busts the Myths."

If you want to have a natural look then yes you are limited to how big you can go.  Lowering of the fold is also something not everyone is in agreement with as it has its own risks and the repair is very very difficult.  Your situation is very common, and if you look at the before/after photos of plastic surgeon you should see a lot of breasts that look like yours.  

Most women who undergo breast augmentation need the inframammary fold lowered to get the implants centered behind the nipple. A short nipple to fold distance is not a limiting factor for breast implant size. But when the fold is lowered the implants may remain high for a period of time after surgery before they settle down. There is also an increased risk for bottoming out, persistent fold lines above the new fold level and the development of the double bubble phenomenon.

To choose the appropriate implants for you, you would have to be seen in person to evaluate your anatomy and review your goals.