lowering VS. raising a crease?

lynn80 · 08-15-2009, 07:09 PM

Hi Dr Mele,
In your experience, what is the difference between lowering or raising a crease? I am planning with my PS a revision surgery at the 6 month mark because my breasts have settled unevenly (the creases were at the same level before surgery and for about 1 month after). I would prefer to raise my left crease because I feel the breast is too low on my chest (lower than before) My PS feels that lowering the right crease would be better. He says that raising a crease is more involved whereas the lowering would be a simple procedure that I could have done under local. He is really trying to sell me on the lowering of the crease. I want to do what is best, not what is easiest. I just feel like the raised crease will maintain a more youthful look I guess. I really just want to get rid of this lopsided look first and foremost but I also want to be happy with my results.

As you can see from the above photo, I am noticeable lopsided and my left breast also began pointing toward the side at about 2 months.
Thanks for any information you can provide.

Dr. Mele · 08-16-2009, 07:25 PM

Dear Lynn80:

Thank you for your question. In general it is easier, and more reliable, to lower a crease than it is to raise one. If the lower implant needs to be positioned more medially, this can only be corrected by reducing the size of the pocket. At the same time the implant can be raised.

This is more involved, and I only do this under anesthesia so that I can work with a fully relaxed pectoralis muscle, assuming the implant is behind the muscle. The problem usually needs to be overcorrected and the implant will appear too high and too medial sometimes for months before it "relaxes" into the planned position. Despite adequate repair, sometimes the ribs are shaped in a way the causes the implant to eventually fall into the same position.

Lowering the crease, is accomplished by opening the lower pole of the capsule and allowing the implant to drop. Recovery tends to be quick and there is minimal discomfort in most cases.

I can't tell you which is going to work better for you, but if lowering will work, it is almost always a quicker and easier operation.

lynn80 · 08-17-2009, 08:20 AM

Thank you so much for explaining both procedures so well!

08-15-2009, 07:09 PM	#1
lynn80 Join Date: Jun 2009 Location: Massachusetts Posts: 210 Thanks: 24 Thanked 76 Times in 61 Posts	lowering VS. raising a crease? Hi Dr Mele, In your experience, what is the difference between lowering or raising a crease? I am planning with my PS a revision surgery at the 6 month mark because my breasts have settled unevenly (the creases were at the same level before surgery and for about 1 month after). I would prefer to raise my left crease because I feel the breast is too low on my chest (lower than before) My PS feels that lowering the right crease would be better. He says that raising a crease is more involved whereas the lowering would be a simple procedure that I could have done under local. He is really trying to sell me on the lowering of the crease. I want to do what is best, not what is easiest. I just feel like the raised crease will maintain a more youthful look I guess. I really just want to get rid of this lopsided look first and foremost but I also want to be happy with my results. As you can see from the above photo, I am noticeable lopsided and my left breast also began pointing toward the side at about 2 months. Thanks for any information you can provide.

08-16-2009, 07:25 PM	#2
Dr. Mele Certified by the ABPS Join Date: Feb 2009 Posts: 274 Thanks: 120 Thanked 290 Times in 152 Posts	Dear Lynn80: Thank you for your question. In general it is easier, and more reliable, to lower a crease than it is to raise one. If the lower implant needs to be positioned more medially, this can only be corrected by reducing the size of the pocket. At the same time the implant can be raised. This is more involved, and I only do this under anesthesia so that I can work with a fully relaxed pectoralis muscle, assuming the implant is behind the muscle. The problem usually needs to be overcorrected and the implant will appear too high and too medial sometimes for months before it "relaxes" into the planned position. Despite adequate repair, sometimes the ribs are shaped in a way the causes the implant to eventually fall into the same position. Lowering the crease, is accomplished by opening the lower pole of the capsule and allowing the implant to drop. Recovery tends to be quick and there is minimal discomfort in most cases. I can't tell you which is going to work better for you, but if lowering will work, it is almost always a quicker and easier operation. __________________ Joseph A. Mele, III, MD, FACS Certified by the American Board of Plastic Surgery Certified by the American Board of Surgery www.DrMele.com

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08-17-2009, 08:20 AM	#3
lynn80 Join Date: Jun 2009 Location: Massachusetts Posts: 210 Thanks: 24 Thanked 76 Times in 61 Posts	Thank you so much for explaining both procedures so well!