Correcting the Inframammary Fold With Breast Revision in Beverly Hills and Hollywood
Posted On: May 03, 2023 Author: The Office of Dr. Stuart Linder Posted In: Breast Revision
During breast revision surgery, a board-certified plastic and reconstructive surgeon must correct the inframammary fold (crease beneath the breast) if it has been malpositioned by previous surgeons.
What Is the Inframammary Fold?
The inframammary fold is where the pectoralis fascia interdigitates underneath the breasts to create a fold; this is the under-hanging area you feel underneath the breast.
The average distance between the areola and the inframammary fold is between 5 and 7 cm from the 6 o’clock position of the inferior areola; however, the standard length is approximately 5.0 cm. It is vital that the fold be maintained during breast augmentation surgery.
Why Does Malposition of the Fold Occur?
Malposition of the inframammary fold occurs all the time with surgeons who are inexperienced or have poor judgment. Placing implants through the belly button (umbilicus) or armpit (transaxillary) can contribute to this.
When using the transaxillary approach, the inframammary fold can be released too much, causing severe bottoming out of the implants. Bottoming out occurs when the nipple is superiorly retroposed (on top of the upper pole of the breast). At the same time, the remainder of the breast tissue descends with gravity, causing the fold to be lowered unnaturally.
Bottoming out is extremely difficult to fix; however, a skilled surgeon can attempt a repair using inframammary skin lifts, formal mastopexy (breast lift), and an internal capsulorrhaphy, where the fold is tightened internally. The internal capsulorrhaphy does not always work, and these sutures can rip out, which can cause the breasts to lose their round appearance.
Fixing lowered inframammary folds from bottoming out is much more complicated than when inframammary folds are high. When they are high, and you have a double-bubble deformity or malpositioning of the implants with the implants too high, the folds can be released by releasing the capsule with an open capsulotomy through a direct periareolar approach.
In the End
The fold is one of the most vital landmarks on the breasts, and board-certified plastic surgeons have the experience and judgment to ensure the inframammary fold is positioned correctly in the operating room. During breast revision surgery, it is corrected so the breast has a normal, natural appearance, and the nipple-areolar complex will be placed centrally.