The Inframammary Fold (IMF): A Poorly Appreciated Landmark in Prosthetic/Alloplastic Breast Aesthetic and Reconstructive Surgery—Personal Experience

Atiyeh, Bishara S.; Ibrahim, Amir; Saba, Salim C.; Karamanoukian, Raffy L.; Chahine, Fadl; Papazian, Nazareth

doi:10.1007/s00266-017-0854-7

Cited by 22 publications

(10 citation statements)

References 42 publications

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“…Also, NAC inset may be more difficult due to kinking. In addition, the concept of fixing the IMF to prevent further descent is another important component of treatment 10 (Figs. 3 A and 4 A).…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the concept of fixing the IMF to prevent further descent is another important component of treatment. 10 …”

Section: Discussionmentioning

confidence: 99%

“…In addition, the concept of fixing the IMF to prevent further descent is another important component of treatment. 10 Iorio et al, 5 who only reported on patients in whom the NAC is displaced medially, suggested that the medial vertical limb of the keyhole pattern should be drawn longer to deal with this problem. They even suggested marking the medial vertical limb up to 10 cm in length.…”

Section: Discussionmentioning

confidence: 99%

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Dealing with the Displaced Nipple–Areola Complex in Macromastia Using a Superomedial Pedicle and Inverted T Pattern

Hudson¹,

Lelala²

2022

Plastic and Reconstructive Surgery - Global Open

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Background:In macromastia, especially in patients with a raised BMI, the nipple areola complex (NAC) may be displaced from the breast midline/meridian. This is poorly documented, and there is little published on surgical management. The aim of the study was to identify the incidence of displaced NAC in macromastia and discuss the management using the superomedial pedicle, by canting the vertical limbs of the inverted T/keyhole. The study also aimed to postulate a theory of pathogenesis. Methods:The study is a retrospective review for a two-and-a-half year period. For study inclusion, the NAC had to be displaced 3 cm or more from the breast meridian. A superomedial pedicle was used with an inverted T pattern. The vertical limbs of the keyhole were canted medially for medially displaced NACs and laterally for laterally displaced NACs. Results: Fifteen patients were identified: three with medial and 12 with laterally displaced NAC. Mean age was 35 years (range 21-61) with a mean BMI of 31 (range 27-37). The mean mass of tissue excised was 1158 g (range 330-1969 g). The mean follow up is 7 months (range 2-21 months). One patient suffered partial areola loss, and 2 patients had a breakdown at the angle of sorrow/inverted T junction. Conclusions: The displaced NAC is not uncommon in women with a raised BMI presenting for breast reduction. Canting the vertical limbs of the keyhole away from the deviated NAC yields satisfactory results in treating patients with a displaced NAC using a superomedial pedicle. A theory of possible pathogenesis is postulated; global attenuation of the breast footplate occurs, leading to lateral and inferior displacement of the NAC.

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Section: Discussionmentioning

confidence: 99%

“…In addition, the concept of fixing the IMF to prevent further descent is another important component of treatment. 10 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Dealing with the Displaced Nipple–Areola Complex in Macromastia Using a Superomedial Pedicle and Inverted T Pattern

Hudson¹,

Lelala²

2022

Plastic and Reconstructive Surgery - Global Open

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“…Senior women were found to have breast ptosis, where the morphological relation of the nipple is lower than the submammary fold and skin brassiere. 22 Hence, the area above the nipple was selected for study. Besides the testing area, the number of markers also plays an importance role in the result performance.…”

Section: Methodsmentioning

confidence: 99%

A hybrid forecasting model for ageing breast deformation during yoga practice

Zhou

Chen

Lau

et al. 2021

Textile Research Journal

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In this work, the deformation of bilateral breasts was investigated with an established hybrid model to predict the nipple movement specifically for senior women during yoga exercise. A motion capture system was used to collect the displacement of 10 markers on the breasts from 11 senior women (average age of 62) during yoga practice and then the data were analyzed by integrating the absolute grey relation analysis (AGRA) and extreme learning machine (ELM). The right and left breasts had the maximum motion amplitude in the horizontal direction but they were respectively featured with contraction and extension during yoga practice. AGRA showed that the nipple motion was highly associated with the vertical region above the nipple for the left breast but the parallel region along with the nipple for the right breast. The ELM model is able to predict the nipple movement within tolerable error (∼0.0037). This study lays a foundation for a better understanding of ageing breast kinematics during yoga poses with limited practical experiments. Besides, the accurate and efficient results can be used not only for yoga pose instruction but also for ergonomic sports bra design.

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“…Its presence and definition are of extreme importance to obtain satisfactory, natural results after various kinds of breast surgery [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

Defining the Inframammary Fold by Liposuction: An Essential Tool in Aesthetic Shaping of the Reconstructed Breast. Technique and Long-term Results in a Series of Patients

2021

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Background A good inframammary fold (IMF) definition and position is essential to achieve a satisfactory and natural result in breast surgery. This structure can be damaged, especially during mastectomies. Multiple methods are reported in the literature to restore IMF or improve its definition. In this study, we present the results achieved in a series of patients treated with subdermal liposuction. Methods We report on all our patients who underwent IMF liposuction between January 2016 and June 2020. Subdermal liposuction was performed with a blunt 3 mm cannula along the new IMF to promote skin retraction and adherence between skin and fascia. Results were evaluated subjectively by the patients and objectively by 8 individuals not involved with the treatment. Results We performed IMF liposuction in 88 breasts (69 patients), aged 21–74 (mean 52) years for 82 implant-based reconstructions, 2 tuberous breasts, and 4 contralateral breast augmentations. Mean follow-up was 28 months (6–64). Subjective results: the overall result evaluated with the VAS scale reached 86.6/100. All the 22 patients interviewed judged as well defined the new inframammary fold. Objective results: in 83% of cases the definition of the inframammary fold was judged as good or excellent, while symmetry with contralateral IMF, natural appearance, and overall aesthetic outcome were judged as good. Conclusion Based on our long-term satisfactory results, we recommend the technique of subdermal liposuction to improve the definition of IMF in breast reconstruction after mastectomy and other breast procedures. It is effective, easy to perform, minimally invasive, and durable. Level of Evidence IV This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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The Inframammary Fold (IMF): A Poorly Appreciated Landmark in Prosthetic/Alloplastic Breast Aesthetic and Reconstructive Surgery—Personal Experience

Abstract: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Cited by 22 publications

References 42 publications

Dealing with the Displaced Nipple–Areola Complex in Macromastia Using a Superomedial Pedicle and Inverted T Pattern

Dealing with the Displaced Nipple–Areola Complex in Macromastia Using a Superomedial Pedicle and Inverted T Pattern

A hybrid forecasting model for ageing breast deformation during yoga practice

Defining the Inframammary Fold by Liposuction: An Essential Tool in Aesthetic Shaping of the Reconstructed Breast. Technique and Long-term Results in a Series of Patients

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