Inframammary Incision Showing Above Fold

Question

Is It Normal for an Inframammary Incision After Breast Augmentation to Show above the inframammary fold or is this a sign of bottoming out?

Otto Joseph Placik, MD · Answer

It is normal and actually desireable for the incision to rise slightly above the natural crease. However, if it tends to do this by more than 2 cm, or seems to be getting worse after the intial 9 moth post-operative period, it may be a sign of bottoming out.

Steven Wallach, MD · Answer

The final position of the incision can be in three spots, bleow the fold, at the fold, or just above the fold.  Above the fold means that the scar will be hidden in a bra.

Robert Brueck, MD · Answer

This is actually good so when you wear a bathing suit the incision will not lie below the bathing suit line.also this is good from the standpoint of putting pressure on the incision so the scar can improve.

Richard Sadove, MD · Answer

As noted by another colleague here it is preferable to be slightly above the fold. The main reason for this is your being free to wear a bikini with confidence. when you raise your arms. Otherwise the scar may visible.

Peter A. Aldea, MD · Answer

Regarding:  "Inframammary Incision Showing Above Fold
	Is It Normal for an Inframammary Incision After Breast Augmentation to Show above the inframammary fold or is this a sign of bottoming out?"

	It is common for the breast fold incision to "move up" the breast. This is the result of several factors: during surgery as the lips of the incision are pulled apart the lower edge is undermined allowing the scar to move up. This is made easier by having the weight of the implant sitting right on top of the freshly stitched incision causing a progressive settling.

	Personally, an incision around the lower areola offers MUCH more visibility, the ability for a much more tailored dissection of the implant pocket AND the ability to be repeatedly utilized for breast implant changes and or lifts.

	Dr. Peter Aldea

Aaron Stone, MD · Answer

In my experience virtually all inframammary fold incision scars migrate up the implant or rather the implant migrates below it. That is why I currently prefer an incision around the areola.

Amy M. Sprole, MD · Answer

The inframammary incision is generally placed at the inframammary crease preoperatively, and with tight skin and/or large implants (or both), it is not uncommon for the incision to be pulled up on to the lower pole of the breast, but it generally remains in a very hidden location, just above the crease. This phenomenon doesn't necessarily mean that you are bottoming out, but that could be another explanation for the incision pulling up on to the lower part of the breast.

Alexis Verpaele, MD · Answer

Dear lady, normally the inframammary incision is planned to fall exactly in the fold. Not above it, neither below. If it was placed correctly in the early months after the operation, the present situation is most likely due to a descent of the implant.

Richard P. Rand, MD, FACS (retired) · Answer

The incision is made in the crease and often stays right there. Especially when using a larger heavier implant, it may descend a little and make the incision ride a tiny bit up onto the breast. This is not bottoming out - just settling. Bottoming out occurs when the scar rides an inch or so up onto the breast. Photos would help here!

John Whitt, MD (retired) · Answer

Without a photo, I cannot Comment on whether or not you are "bottoming out". Inframammary incisions are most commonly placed so that the ultimate scar winds up at or above the fold. The worst situation is for the scar to creep down below the fold and become visible when wearing a bikini top.

Inframammary Incision Showing Above Fold

Answers (10)

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