Transgender breast implant revision to lower IMF? (photo)

Yes, your implants are too high and you will need the inframammary fold lowered. One of the complications of lowering the inframammary fold is that the implants can herniate inferiorly and laterally and bottom out. You may benefit from a repeat donut mastopexy to lift the nipple-areola complex higher and inframammary fold release.

Best Wishes,

Gary Horndeski, M.D.

Thank you for your question. The implant pocket wasn’t adjusted adequately during your previous surgeries and the IMF wasn’t lowered when needed. The implants are sitting too high, and the nipple-areola complex is low, so lowering the IMF could help balance the position. A revision to lower the fold may be necessary. However, since this is a third procedure, a second opinion from a board-certified surgeon with experience in transgender breast surgery is recommended. They can evaluate whether lowering the fold alone will correct the issue or if further pocket or implant adjustments are needed.

Dear Gregarious236767,

breast revision surgery is the most difficult plastic surgery procedure performed. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal properly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery.
Many patients come in to correct poor outcomes from their initial surgeries. The most common problems are due to implant malposition, bottoming out of the implant, poor scarring, and incorrect implant size.
While the type of revision required will depend on the result of the previous surgery and the desired result of the patient, some revisions involve extensive pocket repair that may or may not need specialized external bras.
If you are considering breast surgery revision, you should speak with a board certified plastic surgeon and have yourself properly assessed. Only after a thorough examination you will get more information and recommendations. Also, you have to make sure that your surgeon understands your breast augmentation goals.


Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

You had a constricted lower pole/inframammary fold prior to surgery. You need an incision planned much lower in the "new fold" with obliteration of the previous fold. This is on the spectrum of tuberous breast deformity. This requires a very experienced aesthetic breast board-certified plastic surgeon.

Thanks for your question! It can never hurt to get another opinion. You should feel comfortable with the plan going into a third surgery. Good luck!

It is very likely, based on these photos, that lowering of the IMF would improve position of the implants and result in NAC being on the top of the breast mound. Second opinion consultation is recommended. Good luck.

Measurements are needed to be certain, but a lift would probably do the trick. Lowering the fold can weaken the fold and increase the risk of your implants falling down too low over time. If the fold is lowered, please do not go larger.