Lowering the crease of the breast is usually done when the distance from the bottom of the areola to the fold is less than 6cm., or is very constricted.
Your breasts need to be increased in size with adequate implants, but the skin looseness should allow a fuller implant to be placed.
I am unsure as to how many cc.’s this may equate to without measuring the width of your breast
Your Plastic Surgeon possibly is correct, but without examining you I would be unable to answer this question for you.
If you have any doubts about the advice that has been given to you get a second opinion. (Francis (Frank) William Rieger, MD, Tampa Plastic Surgeon)
Breast implant placemented photo
A breast fold is most often lowered if there is a significant difference between sides to make them more even, if you have constricted or tuberous breasts, or when placing large breast implants that can’t be accommodated by your current breast dimensions.
Lowering the breast folds do not seem necessary when looking at your photos. And, based on the size of the implants you’re considering, lowering them during surgery may risk the implant “bottoming out”. This happens when they migrated down and result in nipples appear too high on a breast mound that is too low. (Adam Hamawy, MD, Princeton Plastic Surgeon)
Breast implant placemented lower position
I think it would be a huge mistake to lower your fold. One can release the muscle w/o lowering the fold, and this will allow more stretching, and a natural result w/o lowering the fold. I try to never lower the fold as it can cause real aesthetic problems. (Gregory Sexton, MD, Columbia Plastic Surgeon)
I rarely lower the breast fold, it is very difficult to lower a fold exactly and have it fixate in the proper position.
Based on your pictures I would be hesitant to lower your fold but would instead opt to fill your breasts evenly. (Jonathan Weiler, MD, Baton Rouge Plastic Surgeon)
In my practice I have rarely found lowering the crease to be necessary. Based on your photos and measurements I do not think it wouod be a necessary maneuver.
Breast implant placemented image
Maybe you should get more than one consult. (Ronald V. DeMars, MD, Portland Plastic Surgeon)
I agree with my colleagues that the inframammary fold is to be treated with respect. It should be lowered rarely and only when necessary.
However, if your surgeon plans an inframammary approach, and based on the implant you describe, your incision would need to be placed 9 to 9.5cm below your nipple. This automatically means that your fold would be lowered. (Eric Pugash, MD, Vancouver Plastic Surgeon)
Breast implant placemented lower
The lower fold of the breast is where the ligaments (Cooper’s Ligaments) that support the breast gland orginate, and therefore I believe that manipulating the inframammary crease is something to avoid.
The ligaments form a “net” that not only supports the breast gland but would also support the weight of the implant as well. When the crease is changed that means that the ligaments are altered as well, which I believe can result in malposition of the implant over time.
If the crease must be changed then the new position could be re-established with sutures to the chest wall. Other plastic surgeons may have a different opinion, but generally the natural support and contour of the base of the breast should be maintained. (Douglas Leppink, MD, Grand Rapids Plastic Surgeon)
Every surgeon is different as well as every situation is different. I try not to lower the fold. What plastic surgeons typically try to due is to increase the distance between the fold and the nipple by releasing the muscle above the natural to allow room to place the implant. (Earl Stephenson, Jr., MD, DDS, Atlanta Plastic Surgeon)
Some women have breasts in which the lower portion is underdeveloped or not very full. In some, the crease is relatively high and the distance from the lower border of the areola to the chest wall is short (less than five centimeters).
In this situation it is sometimes necessary to lower the fold to some degree so that when your implant finally settles it is centered behind your nipple position.
It the fold is left too high then your nipple will be rotated downwards and the implant will look too high when it settles.
This situation is reasonably common and is typical in the tuberous type breast. Looking at your photos, and based on the measurements you have provided, it does not appear that you would need to have your fold lowered much, it at all.
Lowering the fold (and recreating it at a lower level) is associated with an increased risk of implant malposition and can also lead to the condition called “double bubble”, so it is important that your surgeon understands this situation well, and is comfortable managing it appropriately.
On the other hand, if you do have a high fold then lowering can necassary to achieve an aesthetic breast shape. You should discuss this with your surgeon and feel comfortable that they have a thorough understanding of this situation. (Braden C. Stridde, MD, Kirkland Plastic Surgeon)
I do not ever lower the inframammary fold and I think most plastic surgeons do not lower it as well. There may be a need for it with a short nipple/areolar to IMF distance but that is not the routine case. (Thomas Guillot, MD, Baton Rouge Plastic Surgeon)
In your case it doesn’t seem from this online limited evaluation that you need any significant manipulation of the fold. In general the manipilation of the fold is done when the lower part of the breast is too constricted and the fold rides higher. Changing the fold is also done when there is a difference between the two sides. The implant has to be centered below the nipple/breast mound, and that’s why the correct size implant has to be chosen to insure that the soft tissue envelope can accommodate it.
I believe almost always that as the implant settles the fold to nipple distance will get longer and the fold will descend slightly, before the implant will take its final position. Thats why we try not distrupt that natural landmark unless it is absolutely necessary. Finally, good luck with your procedure, and make sure that you always seek the opinion of a board certified plastic surgeon, or two!. (Rami Ghurani, MD, Miami Plastic Surgeon)
Very often, and the size that you are talking is a big size, it needs a very big subcutaneous dissection. (Maria Cristina Picon, MD, Argentina Plastic Surgeon)
Given your photos, which show a normally positioned breast fold, and your history of having been a D cup with nursing, I would recommend not messing with the fold. The fold can be lowered when it is abnormally positioned, and in that setting the benefits often outweigh the risks.
With a normally positioned fold in a patient who has already been the size that is the current goal, I see only risks, and no benefit. I do not lower the breast fold with breast augmentation surgery. The breast fold is sacred territory.
Once it is disturbed it is very difficult to recreate it. And disruption of the breast fold can lead to a double bubble deformity. You should find out why this was recommended and see if something else can be done to avoid that. (Jason E. Leedy, MD, Dubai Plastic Surgeon)