Is my crease lowered enough to accommodate the implants? (Photos)
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Doctor Answers 4
Tissue Based Implant Selection
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
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.
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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.