Submuscular Breast Implantation: Management of the Inferior Fold

There are difficulties in establishing symmetrical breasts during bilateral breast augmentation when the technique involves the submuscular plane. The author has studied the anatomy of the lower chest area that affects the surgical approach to submuscular breast augmentation. In addition to the well-known origins of the pectoralis major muscle and the position of the rectus fascia, adequate development around the external abdominal oblique muscle upper insertion and the serratus anterior insertion is the main factor preventing proper positioning of the breast implants and creation of an adequate pocket. The recognition and treatment of these insertions allows one to achieve better results in performing submuscular breast augmentation.