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

I was told I have a short nipple to inframammary fold length during my initial consultation with my PS. I was told that this would most likely result in the implants taking a longer time to "settle", but I was never told about any size limitations. I'm about one month from my sizing appointment and I want to ensure that I have realistic expectations going into my consultation. I am currently a small A cup and was hoping to achieve a full C-cup/ small D-cup with more upper pole fullness.

Doctor Answers 14

Yes it does...

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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.  

Beverly Hills Plastic Surgeon
5.0 out of 5 stars 63 reviews

Short Nipple to Inframmary Fold Distance

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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.

Steven H. Wiener, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 22 reviews

Breast Implants

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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.

Implant size

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

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Breast augmentation and IMF

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Hi there and thanks for posting,

Rather than the static distance between your fold and your IMF, the more important measurement is that distance when it is stretched.

That will give the best indication as to whether your fold will lower with a larger implant. As to whether or not that is important depends on your overall body habitus which we cannot determine from the photos you have supplied. If you have a relatively long abdomen and short chest, then you could probably tolerate lowering your fold by a couple of centimetres. However if you have a short abdomen relative to your chest then lowering your fold may make you look wider. At that point it is up to you as to what is more important, breast size or overall aesthetics.

As I tell all my patients, it is best to focus on breast shape and overall aesthetics rather than cup size.



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

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The bottom edge of the implant rests at the level of the inframammary fold. If the distance from the nipple to fold is short, and the fold is not lowered, the implant size will have to be small with a narrow diameter or else the nipple will be so far below the "equator" of the implant that it will be low on the breast and pointing downward. So, yes...this would limit the size of the implant used. That is why we lower the inframammary that there is enough lower pole skin (or distance) that it will accommodate a larger/wider implant and the nipple will be in a good position. 

Does a short nipple to IMF limit the size of my implant?

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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.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 80 reviews

Breast augmentation

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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

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 172 reviews

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

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The size of your implant will be based on the base width of your breast which will be measured by your plastic surgeon.  This distance should match the width the breast implant used.  Because of the short distance between the areola and inframammary crease for a significantly larger breast the fold will need to be lowered by your surgeon. For more on sizing please read below:

Your fold may need to be lowered

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Your fold will more than likely need to be lowered to center the implant properly behind the nipple.  In this context, I would be cautious about size since you are removing the natural fibrous hammock that is the IMF and unless properly reconstructed, the implant (particularly smooth implants) can migrated south and bottom out.  Use careful tissue-based planning with your PS to make an educated decision.  

Andrew Gear, MD
Charlotte Plastic Surgeon
5.0 out of 5 stars 29 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.