The Crease Incision Breast Lift: Why It's Not Always the Best Choice

There's a type of breast lift that involves a large incision in the crease of the breast (the inframammary fold) combined with an incision around the areola. It's sometimes marketed as "scarless" — but it's not. It leaves a large scar in the breast crease.

Dr. Killeen doesn't prefer this method for most patients. Here's why.

For patients without implants, this technique often leads to a boxy, flat appearance. The breast doesn't typically look as round from the side, and you lose a lot of the beautiful, natural breast shape that a well-performed lift should preserve.

This technique is sometimes used when an implant has "bottomed out" — meaning the nipple is sitting where it should, but the implant has dropped too low. Cutting off the excess lower tissue in the crease will make things look good right away, but it doesn't solve the underlying problem.

When an implant bottoms out, it's usually because the patient is not a strong capsule former. The scar tissue sac around the implant is too weak to support its weight, so the lower pole of the breast stretches over time. If you don't address that weakness — typically with some form of internal support — the same problem will happen again.

There is one scenario where Dr. Killeen does like to use that lower pole tissue: during an explant procedure.

If a patient is having their implant removed and has excess lower pole tissue, Dr. Killeen performs an auto-augmentation:

1. The lower pole tissue is de-epithelialized (the outer skin layer is removed)
2. The tissue flap is tucked up and underneath the middle portion of the breast
3. This tissue adds volume and helps create a nice, natural breast shape — without an implant

While the crease incision breast lift has its place — particularly in auto-augmentation during explant surgery — it's not typically the best choice for a primary breast lift. The shape it produces tends to be less natural, and when used to fix a bottomed-out implant, it doesn't address the root cause of the problem. A thorough consultation with your plastic surgeon about which lift technique is right for your anatomy and goals is always the best approach.