Anatomical study of the breast superficial fascial system: the inframammary fold unit

The subcutaneous fascial system of the breast was investigated. The aim was to demonstrate splitting of the superficial fascia and the existence of an inframammary ligament. The inframammary region was studied in six cadavers (12 breast dissections) and in 21 patients during breast surgery (12 surgi cal and nine histological investigations). The superficial fascial system i s related to sex, age, breast size, weight and adiposity. In females, the i nframammary fold depends on the situation of the superficial fascia which, without true splitting, becomes deeper due to an absence of fat in the deep subcutaneous space, and on more adherence to the deep fascia through thick ened retinaculum; there is a connective band, the anterior breast capsule, erroneously called "superficial layer of the superficial fascia," and mista ken for "inframammary ligament", which detaches from the superficial fascia . In males, there is a zone of adherence only at the inframammary midline. The microstructure of the breast fascial system at the inframammary region is demonstrated histologically. Surgical implications are suggested.