title: The Inframammary Fold (IMF): A Poorly Appreciated Landmark in Prosthetic/Alloplastic Breast Aesthetic and Reconstructive Surgery-Personal Experience.
abstract: The inframammary fold (IMF) is the most critical visual landmark that affects final aesthetic outcome of augmentation mammoplasty and even post-mastectomy alloplastic breast reconstruction. Unfortunately, structural integrity of this landmark is greatly overlooked and very often neglected. Excessive undermining of the lower breast pole with aggressive disruption/lowering and subsequent poor reconstitution of the IMF scaffold combined with imbalanced implant-tissue dynamics may result in downward implant displacement with creep bottoming and upward tilt of the nipples. The current report reviews the experience of the senior author (BA) over 30 years in breast aesthetic and reconstructive surgery with IMF reconstruction and fixation to the chest wall at the inferior border of the implant. Illustrative cases are presented.
  
  
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authors.affiliation: Plastic and Reconstructive Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Bishara
authors.initials: B
authors.lastname: Atiyeh
authors.affiliation: Plastic and Reconstructive Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Amir
authors.initials: A
authors.lastname: Ibrahim
authors.affiliation: Plastic and Reconstructive Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Salim
authors.initials: S
authors.lastname: Saba
authors.affiliation: Plastic and Reconstructive Surgery, Kare Plastic Surgery and Skin Health Center, Los Angeles, CA, USA.
authors.forename: Raffy
authors.initials: R
authors.lastname: Karamanoukian
authors.affiliation: Plastic and Reconstructive Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Fadl
authors.initials: F
authors.lastname: Chahine
authors.affiliation: Plastic and Reconstructive Surgery, American University of Beirut Medical Center, Beirut, Lebanon. nazareth.j.papazian@gmail.com.
authors.forename: Nazareth
authors.initials: N
authors.lastname: Papazian
mesh_terms: D000328:Adult; D064591:Allografts; D059925:Anatomic Landmarks; D019928:Breast Implantation / Q000379:methods*; D018427:Breast Implants; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008408:Mastectomy / Q000379:methods; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D018570:Risk Assessment; D016896:Treatment Outcome; D014481:United States; D014945:Wound Healing / Q000502:physiology
keywords: Breast augmentation; Breast reconstruction; IMF; Inframammary fold; One-stage breast reconstruction