What You Need to Know About Inframammary Incisions

An inframammary incision (crease or fold incision) is one type of incision used in the placement of implants for breast augmentation.

The inframammary incision is placed in the proximity of the crease where the breast and chest come together.

This crease is called the inframammary fold.

Anatomy of the Breast Relative to the Inframammary Incision

The breast comprises a complex group of tissues, including glandular, fatty and fibrous tissues. The breast is positioned over the pectoral muscles of the chest wall and is attached to the chest wall by loose fibrous strands called Cooper’s ligaments at the fold, there are strong fibrous attachments holding the skin to the chest wall.

The inframammary fold is created by gravity’s pull on the lower portion of the breast, which is not connected to the chest wall by any fibrous tissue. A crease is formed at the point where the breast and the skin come together (normally in the location of the fifth or sixth rib) and where the skin is more tightly connected to the underlying body structure.

How Is the Inframammary Incision Performed?

To perform the inframammary incision, the surgeon selects the optimum location to place the incision — under the breast and close to the inframammary fold. The surgeon makes the incision and creates a pocket in which to place the breast implant. The implant is slid upward through the incision, then centered behind the nipple.

The incision is located to secure proper placement of the implant, but also to reduce scar visibility. Scarring from properly located inframammary incisions should be easily hidden under a swimsuit top.

Advantages of the Inframammary Incision

There are several advantages to the inframammary incision. The first is that this incision allows the implant to be placed in any of the three implant locations:

  • Subglandular

in front of the muscles and fibrous tissues that line the front of the ribs and chest wall.

  • Partial submuscular

behind the breast tissue and partially under the pectoral and other chest muscles.

  • Complete submuscular

Two groups of muscles behind the breast are the pectoralis major and pectoralis minor. The pectoralis major muscles attach to the upper arm area and stretch out across the chest like a fan. The pectoralis minor muscles attach to the shoulder blade (scapula) and stretch down to the ribs.

Another advantage using the inframammary incision, the surgeon works close to the breast, which gives the surgeon optimal visibility while working.

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