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

Only 10 days out, and I know what gets said ALL THE TIME on here. "Too early, wait 3-6 m. it will change." but making sure my breast crease was lowered (if at all) enough to accommodate the 400cc hp silicone unders once I drop and fluff? I started with 2-3cm from nipple to crease before and cant tell if it has been lowered any. Does it look ok? Will the nipple raise? Weight:116 lbs Height:5'4 width breasts:R-13 cm L-12.8 cm nipples-collar bone:R- 19 cm L-18.7 cm height breasts:R- 12 cm L-11.9 cm

Doctor Answers 4

Tissue Based Implant Selection

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!

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 78 reviews

Your creases will be in the right olace

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

Resting fold vs. True inframammary fold vs. lowering the fold

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.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 414 reviews


Your implants should lower with time.  If you have a measurement of your nipple to IMF (crease) distance before and after, you could compare and see the change.  You also look like you have a chest wall deformity which is significantly impacting the shape of your breasts and position of your implants.

Tyler C. Street, MD
Napa Plastic Surgeon

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.