Is my crease lowered enough to accommodate the implants? (Photos)

Thank you for your
question.

I appreciate that
you know you will have to wait 3-6 months for the final results.

Implants initially sit high up when placed under the muscle
because surrounding breast tissues have not become accustomed
to the implant resulting in tightness. You have to allow gravity to take
effect, and overtime, natural tissue expansion will allow the implants to fall
into place causing your breasts to appear more natural, softer, and rounder.
Once that happens, the implant will sit directly behind the breast tissue in a
natural 45:55 breast ratio, and the nipples will move up higher. Currently,
there is excessive upper pole fullness (> 55:45) on both sides, so in time,
this will change.

Please note that it is not uncommon for breasts to heal and
adapt to implants at different rates. In fact, the process I described above
can occur quicker in one breast over another.

With persistent inward and downward breast massaging, along
with pole wraps, the breasts drop.

Now with regards to your question of lowering of the fold, you have to
realize that your body has 2 folds – resting, and true fold. When the nipple-to-inframammary
fold distance is measured with the breast lifted upward to its maximal
stretching point, the surgeon is able to mark your body’s true inframammary
fold.

The true fold is the natural resting fold and this is where
the incision normally takes place and this where the implant will ultimately come to
rest on the chest wall.

That being said, the inframammary incision will be lowered beyond
the true fold to provide symmetrical, proportional results when trying to accommodate
a larger implant. Lowering the fold results in adequate distribution of filling
of the breasts especially in the upper pole of the breast.

However, most surgeons would not excessively lower
the fold because it can result in breasts appearing too low on the chest wall (“bottoming
out”) and this is not aesthetically pleasing.

 

If your nipple to inframammary fold is enough to accommodate
the implant, then a larger implant is suggested until the breasts can be filled
to their maximal extent. We want to always avoid “the rock in the sock”
appearance.

 

Please continue to have regular follow-ups with your surgeon
to make sure your breasts are healing beautifully. Their recovery instructions
should take precedence over all else you read here as they are better informed
about your surgical details.

Hope this helps.

Hello,If your nipple to crease distance was '2-3 cm', 400 cc implants should not have been chosen. It is likely proper measurement would have indicated a distance of about 6 to 7 cm, still too small for such a large implant. Lowering the crease is a dangerous game that should be done with caution by the most expert of surgeons. Still, changes do occur with time, so sit tight.Best of luck!

Hi Leela001,Thanks for reaching out with your question. The inframammary fold is a critically important structure that once violated, is very hard to recreate. Unless a fold is VERY short, as in a constricted/tuberous breast, it's generally a dangerous practice to lower a fold to accomodate a big implant. Instead, it's much safer to choose  an implant of the same diameter as the breast "footprint" so that the implant sits centered behind the nipple/areola. In your case, it looks like your nipple-fold distance was pretty normal pre-op, so aggressive fold-lowering would be unnecessary. Right now, as you know, the implant is riding high and your pectoralis muscle is tight and swollen. As the muscle relaxes, your breasts will start to look much rounder. Initially, for the first several months, you'll likely have a little bit more implant above compared to below the nipple based on the size and diameter of the implants. But gravity generally wins and in time, the lower pole will stretch out and the nipple will looks centered. Try not to worry too much about the fold position, it looks intact and in the right place. Best of luck,Dr. Weintraub