FOCUS ON THE BREAST FASCIAL SYSTEM - A NEW APPROACH FOR INFRAMAMMARY FOLD RECONSTRUCTION

Anatomists and surgeons have underestimated the importance of understa nding the anatomic connective frame of the inframammary region. The su bmammary fold does not originate as a self-governing unit but depends on breast mould and on a fine superficial fascial system suspension. T he authors investigated the inframammary fold anatomy and subcutaneous breast territory in cadaver and live dissection with histologic analy ses, without sharing the theories about superficial fascia splitting a nd inframammary ligament existence. The authors have understood that a reliable and fine correction of inframammary fold contour in breast r econstruction may only be achieved by an empirical surgical procedure that exclusively concerns the restoration of the superficial fascial s ystem. The literature on this subject is reviewed. Fascial anchoring s urgery, after capsulotomy and superficial fasciotomy, without lo lower thoracic advancement flap or deep subcutaneous undermining, was perfo rmed for 100 breast reconstructions after biodimensional device progra mming. Technique and results are also discussed.