Repairing Damaged Inframammary Fold After Skin Sparing Mastectomy and 3 Revisions. Can I Get a Repair?

I had a skin sparing mastectomy with immediate muscle sparing free tram reconstruction less than 2 years ago. I have since gone under general anesthesia 3 times or revisions. I am still not pleased with the look and sent photographs to another plastic surgeon. I was told my breat surgeon had cut through the inframammary fold. Can this be repaired with a desirable outcome and will the repair last?

Doctor Answers 3

Inframammary fold and breast reconstruction

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One of the most difficult issues when performing immediate reconstruction is the inframammary fold.  Many breast surgeons will violate this structure during the mastectomy even though most times it is not necessary to do a complete mastectomy.  I usually recognize and repair this at the time of the initial reconstruction, but many times it needs to be repaired secondarily.  It is usually not too difficult a procedure.

Breast reconstruction, nipple reconstruction, breast cancer, DCIS, mastectomy, TUG flap, DIEP flap, Latissimus flap, fat graft i

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Yes the inframammary fold in many mastectomies is dissected in order to complete the cancer operation.  We mark the folds before the mastectomy and reconstruct the fold prior to completion of the reconstruction normally.  These repairs don't always work and may need to be revised.  There are multiple ways to reconstruct and inframammary fold.  You can also elevate the entire reconstruction and change the position of suture to the rib below.  Of course in the prep picture if the arms were elevated you can see if the fold is lower or higher.

Inframmamary Fold can be reconstructed in most cases

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Without photos it would be impossible to answer your specific concerns. In general however it is possible to reconstruct the inframammary fold by a number of surgical techniques such as the Ryan procedure

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