Will Making a New Inframammory Crease Cause a Double Bubble?

I just had my consult today regarding breast augmentation. My doctor said that he would have to create a new inframmamory crease about a 1/4 of an inch lower my existing crease. His reasoning is because my breast are somewhat droopy and he doesn't want the implant to sit above my breast. Will this method cause my breast to look natural? I'm afraid of the "double bubble affect" and looking like I have deformed breasts. Please help! My surgery is 10 days!

Doctor Answers 5

Getting a lift from lowering the inframammary fold

The only way I have reliably found to correct a drooping breast is to do a lift.  

If the drooping is mild, what we call Grade I, with the nipple at or above the fold, the augmentation alone will usually give a satisfactory lift and projection to the breast and nipple/areola without a formal lift.

If the nipple is below the fold and the breasts are droopy, then it requires elevating the nipple/areola surgically, i.e., a lift with whatever technique is appropriate.

Lowering the fold is done when there is truly a lack of skin between the nipple and fold on stretch. For example, for a 350 cc implant you need about 9 cm of stretched skin and you might only have six.  Then, of course, you must lower the fold to recruit some upper abdominal skin to cover the implant.  The new fold must be well secured to prevent bottoming out.

Frankly, lowering the fold 1/4 inch is so minimal that I would hardly consider it lowering the fold. It often goes down that much in an augmentation anyway just from skin stretch. If there is that much droopiness that your plastic surgeon is concerned that the implant will be too high in relation to the breast mound and nipple, then you should really be asking if a lift is necessary in addition.

Mountain View Plastic Surgeon
5.0 out of 5 stars 48 reviews

Lowering the fold in breast augmentation.

In certain cases, lowering of the inframammary fold can improve the overall look of an augmentation. Concerns regarding a double-bubble are valid. Care must be taken to completely release the fold and if the fold is lowered significantly, reestablishing the crease can help prevent this complication. Another option is to perform an augmentation mastopexy where a lift is combined with the augmentation. This allows adjusting the breast tissue to sit in a more appropriate position over the implant without lowering the fold. 

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 25 reviews

Double bubble deformity

The double bubble deformity can occur if a new crease is dissected much lower than a natural inframammary crease, especially in a well-formed breast.  A lowering of about a quarter inch is not very risky.  In general, an experienced plastic surgeon can minimize the creation of the double bubble.

Bruce E. Genter, MD, FACS
Abington Plastic Surgeon
4.3 out of 5 stars 16 reviews

Picture would have been helpful

Your surgeon is correct and lowering the inframammary is done for specific conditions. You may be a good candidate but not possible to be sure without pictures or personal examination.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.8 out of 5 stars 122 reviews

A new breast fold or a double bubble

Very often in breast augmentation the natural breast fold will lower as the tissue envelope relaxes to accommodate the breast implant. This is the process of an implant 'dropping' after a very full augmentation, relaxation of the lower breast skin allowing the implant to settle in. If the skin is firm, and the breast fold is high and tight, you are correct in that there is a risk of the implant pushing below the breast fold and under the breast to cause a double bubble. If your surgeon is experienced he should have the skill to avoid one.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 42 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.