Is Raising my Low IMF the Same As a Breast Lift? (photo)

Question

Hi. It's been suggested my IMF is very low, and that raising the fold could improve my shape. Is this the same thing as a lift? I would love to have a fuller, rounder shape, more circular. I feel like my breasts are long and I have no cleavage. The right almost looks like a v shape. I have very small high profile saline implants and I wonder if they should be filled more to improve the shape and fullness as well? Thanks so much for your suggestions! This will help me when I go back to see my PS

Michele A. Shermak, MD · Answer

Raising the IMF has been a great technique for tightening up the breast. It is unclear if you are showing before and after photos, and what the right photo represents. The photos on the left seem to indicate that lifting the IMF would be a very good way to go. The space around the breast implant is too large so it needs to be tightened up. It's possible that may require some internal tightening sutures as well at the time of surgery. More often than not, if you want more volume, then you need to change the implant entirely rather than fill up the one you have. Typically you cannot add enough to make much of a difference.

Gary M. Horndeski, MD · Answer

Your photographs show that the implants have descended inferiorly and are bottoming out.  The capsule for the implant needs to be plicated inferiorly to give you a lift or smaller implants placed.  A mastopexy is an operation that lifts the breast tissue NOT the capsule of an implant.  If you would like your shape and fullness improved, you will need a mastopexy through a peri-areola incision.  It would move your own breast tissue more medial and up as well as your nipple.  This can be done avoiding the vertical scars or the boat anchor incisions.

	Best of Luck,

	Gary Horndeski, M.D.

Vishnu Rumalla, MD · Answer

Thanks for your question.  I believe your revision with Stattice really improved your shape.  I am not sure what your final expectations are, but you are still early with changes to come.

Don W. Griffin, MD · Answer

It appears that your implants have bottomed out. Horizontal excision along the IMF, and internal pocket plication can help to raise the IMF and improve your appearance. In women with a long torso like yours, I prefer to use the moderate or moderate plus profile implants due to their larger base diameter which will place more implant above the level of the nipple.

Renato Saltz, MD · Answer

No raising your inframammary folds is not the same thing as a lift. Your pre-operative photos show a classic indication that your implants have "bottomed out". Your early post operative results seem to show that the reconstruction to your inframammary folds was successful.

Peter A. Aldea, MD · Answer

The inframamary fold (IMF) is a discrete anatomical structure where the chest ends and the breast begins. It is a dense attachment of the breast skin to the chest cage. Certain breast operations intentionally disrupt the IMF to place a large implant (rarely a really god idea) or perform a mastectomy ( again not a good idea as it makes breast reconstruction much harder).  A sharp, crisp curved IMF is crucial in creating an attractive breast and there are several methods to create it.

	A Breast Lift refers to several operations which remove excess skin from the lower half of the breast to push the breast contents upwards and reposition a sagging nipple complex to the center of the breast mound creating an attractive round breast with a centrally located nipple. 

	In your case you appar to have had way too much surgery. It is hard to tell when your IMF was destroyed during your (? Overly done) Breast reduction which was then followed by an attempt to add volume to the breast by the placement of large breast implants. These in turn, expanded the lower pole of the breasts further weakening the IMF and resulted in implant descent and "Srar Gazing" nipples.  Your (last) surgeon corrected your implant positions by using Strattice stitched to the rib cage holding up the implants thereby recreating the IMF's. You have a nice result considering where your surgeon started from. I would stop here and not have any more operations. Ths s a clear example where"Better is the enemy of Good".

Steven Wallach, MD · Answer

You have bottoming out and restoring the fold is the way to go.  A lift involves multiple things including tightening the skin envelope and lifting the tissues.

Darryl J. Blinski, MD · Answer

NO! Best to be examined in person for these issues, even though your posted photos help. I believe acellular dermal matrix and relifting could improve the bottoming out.

Peter E. Johnson, MD · Answer

The low breast fold is more to do with the bottomed out breast implant with the point of projection well below the nipple. It appears that the repair has gone well raising and centering the implant within the breast. It is possible to change the implant profile or base diameter to adjust the fill, though you have just been through a difficult situation. Wait a bit until the result is stable and well healed.
	Best of luck, peterejohnsonmd.com

Tom J. Pousti, MD · Answer

Thank you for the question and pictures.

	It seems like you have had a good repair of the bottoming out of the breast implants. I would suggest that you wait an additional 6 months before evaluating the end results of surgery. Once the repair is solid then use of different size/profiles of breast implants may be considered to improve fullness/cleavage concerns.

	Best wishes.

Is Raising my Low IMF the Same As a Breast Lift? (photo)

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