Background and objective.

Plastic surgeons continue to search for measures to create perfect breasts and avoid complications and undesirable results in aesthetic breast surgeries. We set out to evaluate and describe the deep relationship of the clinical submammary fold of patients in the thorax, to establish its correct position and effectively recreate or reposition it in aesthetic breast surgery.

Methods.

A descriptive, prospective and longitudinal study was performed. The population consisted of 16 female patients (32 breasts) underwent primary aesthetic breast surgeries, mastopexy with or without implants. In all the breasts, during surgery, and as part of the surgical dissection necessary for the intervention, the internal anatomy of the clinical submammary fold was documented, describing its components (subcutaneous cellular tissue, mammary gland) and its relationship with the chest wall (muscle, ribs and intercostal space).

Results.

The clinical submammary fold was more closely related to the subcutaneous cellular tissue and projected more frequently towards the sixth rib. We found that it was composed of a single tissue in 43.8% (14 breasts), of which 92.84% (13 breasts) were subcutaneous cellular tissue and 7.14% (1 breast) was mammary glandular tissue. In 56.2% (18 breasts) it was the combination of subcutaneous cellular tissue and mammary glandular tissue. Regarding the relationships with deep structures of the clinical submammary fold, it was found in costal arches in 75% (24 breasts), more frequently the sixth costal arch, and in 25% (8 breasts) in intercostal spaces, more frequently in the fifth one.

Conclusions.

Based on our findings, we establish guidelines to locate the clinical or preexisting submammary fold in a more anatomically correct position and thus be able to couple it with the surgical submammary fold (retropectoral) in primary and secondary breast surgeries.

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