Single-centre studies such as this are important in ensuring that standards of surgery are maintained in a community setting.

In 2019, breast augmentation was among the top five cosmetic surgical procedures performed by plastic surgeons in the United States, with 193,073 reported cases. 1 Decision-making with regard to implant selection and preoperative planning has been widely debated in the literature, with a broad range of reported approaches and published aesthetic breast surgery algorithms. A recent systematic review by Adams and Mckee critically examined many of these studies and supported tissue-based planning as the optimal method for preoperative planning. 2 Despite this focus on tissue-based planning, no previously published algorithm has specifically addressed the role of the native inframammary fold in primary breast augmentation. Inframammary fold location is one of the tenets of the "high five" methodology; however, baseline inframammary fold characteristics are not taken into consideration. 3 The method described by Hedén relies on thoughtful evaluation of breast width and skin envelope laxity before primary breast augmentation, but it does not include inframammary fold