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Dr. Linder's Blog

Fold Breast Revision in Beverly Hills and Hollywood

Posted On: December 29, 2008 Author: The Office of Dr. Stuart Linder Posted In: Breast Revision, Home

As an expert in the field of breast revision surgery, it is essential that the inframammary fold or the fold of the breast be corrected if it has been malpositioned from previous surgeons.

The inframammary fold is where the pectoralis fascia interdigitates underneath the breasts to the subdermic and creates a fold, which is the under-hanging that you feel underneath the breast. Normal distance is between 5 and 7 cm from the 6 o’clock position of the inferior areolar to this inframammary fold. Standard is approximately 5.0 cm. It is absolutely vital that the fold be maintained during breast augmentation surgery.

Malposition of the inframammary fold occurs all the time with surgeons who are inexperienced or have poor judgment. Placing implants through the bellybutton or umbilicus or transaxillary, although in some hands good results can be obtained but many results are horrific. In fact, the inframammary fold through the transaxillary approach can be released too much causing severe bottoming out of the implants in which the nipple is superiorly retropositioned, in other words, on top of the upper pole of the breast, while the remainder of breast tissue has descended with gravity and the fold has been lowered in an unnatural fashion. This is extremely difficult to fix. Ways of repairing it include inframammary skin lifts and formal mastopexies and an internal capsulorraphy, where the fold is tightened internally. The internal capsulorraphy does not always work and these sutures can rip out or the folds can look strange and not round in appearance

Fixing lowered inframammary folds from bottoming out are much more difficult than when inframammary folds are high. When they are high and you have double-bubble deformity or malpositioning of the implants with the implants too high, the folds can be released by releasing the capsule, performing an open capsulotomy through a direct periareolar approach.

So, the fold in breast revision surgery is one of the most vital landmarks on the breasts and Board Certified Plastic Surgeons have the experience and judgment to make sure the inframammary fold is positioned correctly in the operating room and during revision surgery it is corrected so that the breast once again has a normal natural appearance and the nipple areolar complex will be placed centrally.