Lowering the crease, should I be worried? (photos)

I just had my Pre-op appt for BA (Transaxillary, saline under muscle). My PS is lowering my crease to center the implant behind nipple. He warned I'll be able to see the original crease, giving the double bubble look, but it will smooth out & fade over time as it stretches. After research, it sounds like he is creating this "bottomed out" issue on purpose...? Should I be worried, or confident in his reputation, portfolio, and 20+ years experience? I'm so nervous. Thank you!

Doctor Answers 17

Need breast lift

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Thank you for your question and photo.  What you appear to need most to give the most desirable results is a full breast lift.  You have ptosis (sagging of the breasts) and would benefit a great deal from the areola reduction as well.  This procedure can be also combined with a breast augmentation to give your breasts increased volume if that fits your goals.

All the best,

Dr. Results
Miami, FL

Breast Implants

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Thank you for your question about breast implants.

I would be very concerned about getting a transaxillary breast augmentation alone.  You are at high risk for a double bubble or snoopy deformity.

A breast lift with implants may be a better option for you.

To be sure, see two or more experienced, board-certified Plastic Surgeons in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have breast lift with implants surgery.

I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 221 reviews

Lowering the breast crease, should I be worried?

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I agree with others that based on your photos you need a breast lift with implants. To understand the risks of implants alone when you need a lift please look up "snoopy deformity" after breast augmentation.

Lowering of the crease

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 From what I can tell from your photos, you would be a much better candidate for a breast lift and an implant. Even with a significant amount of lowering of your crease, which does put you in an increase risk of bottoming out, I still think you will have the look of a breast hanging over an implant. I would recommend getting a second opinion as what you see on a photo may not be exactly what you would see in real life. Good luck.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 58 reviews

Lower Breast Fold vs Lift

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Thank you for your question and photos. It appears that you need a lift (mastopexy) as well as an augmentation.  I do not agree with and would not perform lowering of your fold to center your nipple. Please see a board certified plastic surgeon for a second opinion. Hope this helps!

Get a second opinion

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From your photos, you look as if you need a breast lift with an implant. Your surgeon may be lowering your crease to avoid the lift. I would get a second opinion from another board certified plastic surgeon in your area (link below) and see if they line up. Best, Dr. Nazarian

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 56 reviews

Surgeon is lowering crease for ikmplants

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  • I think your surgeon wants to lower your crease because your breast is so low on your chest that an implant will not look right.
  • You appear to need a breast lift - the stretch marks showing on the side of your breast show the breast skin has lost elasticity.
  • You should get a second opinion before proceeding with surgery - and you truly must do so if he is not a Board Certified Plastic Surgeon. It does not sound like the ideal plan for you.
  • Always see a Board Certified Plastic Surgeon.
    Hope you find this information helpful. Best wishes.


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From your photos, you appear to be a much better candidate for augmentation with a breast lift.  I have not had any luck with double bubble creases relaxing. If anything, they seem to get worse.  I would also avoid a transaxillary approach with your anatomy.  Perhaps consider a second opinion...

Lowering your crease is a mistake in my opinion

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I think you are headed for trouble. You may have told your doctor you don't want a lift, but you need one. You may think that if you just put in large implants that your skin will raise up, but it won't. You may have said "I don't want the scars of a lift", but it remains your best answer. Augmentation or not, you will need a lift. putting in large implants may just make you look top heavy. Double bubbles don't always relax. I would recommend a second opinion from a Board Certified Plastic (not cosmetic) Surgeon.

David Janssen, MD, FACS
Oshkosh Plastic Surgeon
5.0 out of 5 stars 29 reviews

Lower the Crease for Breast Augmentation?

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  • You would benefit from a breast lift along with augmentation.  In fact, I would not perform a breast augmentation for you without a lift because the results from a breast augmentation alone would not be very pleasing to you. You have a lot of glandular ptosis. 
  • Your infra-mammary fold/crease does not need to be adjusted at all. It should be left alone.
  • And, I commonly lower the crease in patients when it is indicated such as those women who have a constricted lower pole (which you certainly do not).  
  • Please get a second opinion from a board certified plastic surgeon.
  • Thanks for sharing!

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.