Are there any risks in lowering or raising a breast crease? Or should I leave it alone? (photo)

Sounds like you are very insightful, I really try not to mess with normal anatomy. My guess is your folds were originally different and even if they look perfect on the table the long term results are unpredicatable. GOOD LUCK!

I think that many surgeons feel that trying to lower a breast crease is easier than raising one. But, I think that lowering a breast crease is much less predictable and more likely to require even additional surgery. What you need to do is to correctly identify what the problem is exactly and then precisely correct what is wrong. If one breast implant is too high, then it should be lowered. If one is too low, it should be elevated. Based on these photos (which is never as accurate as a physical exam), I would agree that the lower of the two (your left on this photo) should be elevated for best results. A well performed capsulorrhaphy procedure can be very effective in achieving this goal.  

You do have significant differences in symmetry between the right and lift breasts.  With the shape differences I would want to know if you have a capsular contracture on the right side causing the elevation of the right inframammary crease.  There are many options for you to consider but a good choice may be to place the a textured shaped anatomic implant in a new pocket (called a neopocket) and adjust the implants so that the crease is at the same level on each side.  The texturing as well as a new pocket for the implant will help to hold it in place.  There are other options available but this is just a suggestion.  

Changing the position of the breast crease is often necessary in order to provide a natural looking result from breast augmentation. We all have seen even small breast implants look unnatural because they ride to high on the chest wall with too much breast tissue above the nipple and too little breast tissue below the nipple.  If the inframammry fold is altered there are steps necessary to prevent the implant from bottoming out. It is important ant you select a plastic surgeon with a lot of experience in this area. Start by looking at a lot of before and after photos. and then do a lot of homework on your plastic surgeon before selecting someone to make a permanent change to your body.

Actually your right breast crease appears higher than the left. It is important to know if this is due to an isolated malposition of the fold itself or due to a capsular contracture. If it is due to a capsular contracture a partial or complete removal of the capsule would be recommended. By removing the capsule at the fold it will move downward somewhat (assuming the contracture does not return). However, if it is due to an isolated  post- operative inframammary fold asymmetry my recommendation would be to raise the left fold. Attempts to lower a fold can disrupt the inframammery fold retaining ligments. If this occurs things may appear symmetric in the operating room, however over time may "bottom out" creating a worse problem than you started with. Be certain you be evaluated by a Plastic Surgeon with a long standing vast experience in breast augmentation and breast revision procedures.

Moving the breast fold is possible, but there is great difference between moving it down vs. up.  Moving it down agrees with gravity and the weight of the implant, and therefore, most often is succeeds.  Moving it up is going against gravity and the weight of the implant, as for that reason, it is more likely to fail or not hold.  This doesn't mean it can't be done - it just means we can not have the same level of expectation for success.  Ultimately it comes down to (a) whether you care enough to move the fold, and if so, (b) whether you're willing to take the likelihood that it may not work as well as you and your surgeon hope it will.  There are no wrong decisions here, you just have to take a calculated chance.

Lowering a breast case can result in complications  like a double bubble when the implants falls below the elevated fold.

That is always the question..."which one do you like better". They both look good, it is just that they don't match. It is easier and more predictable to lower the higher one than to riase the lower one. So...if you don't feel strongly about raising and mostly just want better symmetry, I would suggest lowering the higher one. If you really want the lower one higher, then accept the extra work.cost/risk of recurrence and go for it!

The additional costs for lifting crease needs to be explained. And lifting the crease is a much more difficult procedure... 

Yours is a case where a good, long discussion coupled with an exam and a review of your photos would really help define both the problems and the solution.  I would agree with others that raising a crease is more predictable than lowering one but when I look at your breasts, the left side is more aesthetic and more pleasing, though lower than the right. To elevate the left side just to look like the right, when the right does not look ideal, is a mistake in my opinion.  Yours is too complicated a case to make absolute decisions over the internet but I think that if you have found the correct doctor for you, the discussion, augmented with what you have read here, can be a pretty educated one.Best,Dr. Pyle