INFRAMAMMARY FOLD POSITIONING
This preoperative photograph shows a patient with significant asymmetry of the inframammary fold. The inframammary fold is one of the most important, if not the most important, landmarks on the breast when performing breast augmentation surgery.
Notably, on this patient her right inframammary fold is significantly lower than the left and also notable is a larger nipple areolar complex on the right and breast volume. As a result, it is extremely important that the inframammary fold on the right not be lowered so as to prevent bottoming out which would occur even if the implant is placed in its normal natural position. During surgery, the inframammary fold was not violated and the implant was placed approximately 1.1 cm above the inframammary fold in order to regain symmetry with the left. The left inframammary fold will be slightly lowered to regain symmetry with the right and 20 cc more fluid is placed in the high profile Natrelle saline implant on the left to regain symmetry to the contralateral side.
Inframammary folds are difficult to correct once asymmetry occurs postoperatively. In a patient like this, preoperative evaluation and screening is vital to prevent what can easily be an asymmetry postoperatively with the right fold positioned lower. The inframammary fold attachment should not be violated on the right side and the implant will be placed superiorly and an upper pole band will be placed for only five days in order to prevent increased external inferior pressure which could lead to severe bottoming out.