My doctor and I agreed to lower my inframammary fold due to some slight tubular deformity and ptosis. There are some problems with the outcome and its now been 6 months since surgery. First, my original crease cuts across the implant on both breast creating a double bubble effect. Second, my implants seem to have settled too low and one has even slid under the incision and the edge sits low on my rib cage. Third, because of where my implants have settled, I have no fold and and scar is visible.
Can a Lowered Inframammary Fold Be Corrected?
Doctor Answers 9
Capsulorrhaphy for double bubble deformity
It sounds as if you may benefit from a revision with a capsulorrhaphy to recreate and elevate the inframammary fold and close off the pocket.
Tuberous breasts and double bubbles
The tuberous breast presents one of the toughest starting points for breast augmentation. What you are describing are among the complications which are a higher risk in correcting the tuberous breast. You will need surgical revision. A photo would be helpful here to discuss possibilities.
Inframammary fold and tuberous breasts
Sometimes the fold has to be elevated in tuberous breast deformities and scored to that the lwoer pole can expand. If the fold needs to be reinforced because of the problems that you are having, itmay be necessary. I couldn't say without an exam.
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Recreation of the inframammary fold
A tubular breast reconstruction is a difficult procedure. Photographs would help tremendously. From what you describe, it sounds as though you have 2 separate issues:
- Incomplete release of the constricting bands in the lower breast parenchyma
- Loss of definition of the inframammary fold
Correction of these issues is difficult, but would be aided with the use of a dermal matrix (Alloderm or Strattice). A dermal matrix is essentially a collagen sling which is used to define the implant position and provide support. When the lower breast parenchyma is released to correct the constriction, the breast tissue spreads over a larger area, essentially thinning. The dermal matrix helps support the implant to offload this breast tissue and decrease the risk of progressive tissue thinning as the breast ages. Also, the matrix will allow for precise placement of the breast fold and offloading of any fold repair that is necessary.
Tubular Breasts aren't easy
Tubular breasts are difficult cases. Pictures in case would be extremely helpful. There are several techniques to treat tubular breasts and lowered folds. Scoring the breast internally at your old fold may help lessen the appearance of your double bubble just to give you one method to address one of your issues. Again pictures would be great.
Asymmetrical inframammary fold position can be corrected with surgery.
Asymmetry of the infra-mammary folds is fairly common pre-op, and therefore is fairly common post-op. I usually point this out to my patients before surgery so that they know what to expect after surgery.
If this bothers you significantly it can be revised with another surgery which uses sutures to help shape and or move the fold into a higher position. Lowering the fold is much easier and requires only further separation of the tissue inferiorly.
The presence of tubular breasts is a difficult problem to completely correct for some patients and is a frequent cause for re-operation.
Correction of double bubble deformity
Tubular breasts are a tough problem and despite the best efforts what you have described my occur.
It is possible to revise and reposition the inframammary fold. Typically the surgeon will place a row of sutures inside as a "sling" to elevate the fold. Some surgeons may also use AlloDerm (cadaver dermis) as extra padding/protection, especially if the skin is very thin.
Best of luck.
Please send more information and pictures
The result that you have explained is very common for the patients with tubular breast and large implants. You will need to have repair of the inframammary fold and also release the lower pole of the breast. Please send front and lateral picture .
Inframammary Fold and Tubular Breasts
Unfortunately, when you are dealing with tubular breast deformity, it can require alot of work to really get eveything to sit and stretch the way it is supposed to. Without seeing pictures, it is hard to know exactly what is going on, but it sounds like the lower tissues did not release enough internally. Because of this, they do not stretch out the way they are supposed to, and instead of the breast tissue stretching, the implants push on the fold and end up sitting lower then they should. It sounds like you may need to go in there, release the tissues more, and reinforce the inframammary fold area with sutures, capsule work, ore even some sort of biologic material like Alloderm/Strattice. I hope this helps.