{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T05:45:06Z","timestamp":1780379106166,"version":"3.54.1"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Previous aesthetic breast surgery algorithms have not addressed the importance of evaluating the native inframammary fold before primary breast augmentation. In the authors\u2019 experience, assessment of native inframammary fold anatomy significantly impacts surgical planning and technique. Failure to adequately evaluate and manage the inframammary fold leads to many of the common problems of the lower pole, including double-bubble deformity.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>The authors assessed the inframammary fold preoperatively in 2192 consecutive patients undergoing primary breast augmentation between June of 2014 and December of 2018. A novel classification of inframammary fold morphology was devised based on review of standardized preoperative photographs. Outcome assessment was performed postoperatively at 3-month intervals.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>The authors identified four clear inframammary fold subtypes based on their clinical appearance, ranging from the nonexistent type F0 to the well-formed and fixed type F3. The key outcome measure examined was the presence of double-bubble deformity postoperatively. There were three total cases of double-bubble deformity identified in our cohort (&lt;1 percent of patients). All cases of double-bubble deformity occurred in patients with a type 3 fold.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>The inframammary fold defines the inferior boundary of the lower pole of the breast and is a critical landmark to the aesthetic breast surgeon. The authors describe a unique and simple inframammary fold classification system that assists in selection of the appropriate approach to the inframammary fold in addition to implant dimensional planning. The authors have found that this system\u2014in particular, the identification of the type F3 inframammary fold\u2014has minimized the risk of inframammary fold\u2013associated complications in over 2000 cases.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CLINICAL QUESTION\/LEVEL OF EVIDENCE:<\/jats:title>\n            <jats:p>Therapeutic, IV.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/prs.0000000000008563","type":"journal-article","created":{"date-parts":[[2021,10,15]],"date-time":"2021-10-15T18:26:10Z","timestamp":1634322370000},"page":"903e-914e","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":15,"title":["A Novel Classification of the Inframammary Fold for Use in Primary Breast Augmentation"],"prefix":"10.1097","volume":"148","author":[{"given":"Nicole A.","family":"Phillips","sequence":"first","affiliation":[{"name":"From the Breast Academy; and private practice."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lincoln S.","family":"Millan","sequence":"additional","affiliation":[{"name":"From the Breast Academy; and private practice."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Miroshnik","sequence":"additional","affiliation":[{"name":"From the Breast Academy; and private practice."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke","family":"Stradwick","sequence":"additional","affiliation":[{"name":"From the Breast Academy; and private practice."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig","family":"Layt","sequence":"additional","affiliation":[{"name":"From the Breast Academy; and private practice."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,10,13]]},"reference":[{"key":"R2-20250502","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1097\/PRS.0000000000002623","article-title":"Matching the implant to the breast: A systematic review of implant size selection systems for breast augmentation.","volume":"138","author":"Adams","year":"2016","journal-title":"Plast Reconstr Surg"},{"key":"R3-20250502","first-page":"2005","article-title":"Five critical decisions in breast augmentation using five measurements in 5 minutes: The high five decision support process.","volume":"116","author":"Tebbetts","year":"2005","journal-title":"Plast Reconstr Surg"},{"key":"R5-20250502","doi-asserted-by":"crossref","first-page":"966","DOI":"10.1093\/asj\/sjw011","article-title":"A four-layer wound closure technique with barbed sutures for stable reset of the inframammary fold in breast augmentation.","volume":"36","author":"Montemurro","year":"2016","journal-title":"Aesthet Surg J"},{"key":"R6-20250502","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1093\/asj\/sjv178","article-title":"The inframammary fold (IMF) fixation suture: Proactive control of the IMF in primary breast augmentation.","volume":"36","author":"Campbell","year":"2016","journal-title":"Aesthet Surg J"},{"key":"R7-20250502","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1097\/00006534-199809020-00017","article-title":"The intradermal anatomy of the inframammary fold.","volume":"102","author":"Boutros","year":"1998","journal-title":"Plast Reconstr Surg"},{"key":"R8-20250502","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1097\/00006534-200002000-00011","article-title":"Inframammary fold: A histologic reappraisal.","volume":"105","author":"Muntan","year":"2000","journal-title":"Plast Reconstr Surg"},{"key":"R9-20250502","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1097\/01.prs.0000436798.20047.dc","article-title":"Understanding the fascial supporting network of the breast: Key ligamentous structures in breast augmentation and a proposed system of nomenclature.","volume":"133","author":"Matousek","year":"2014","journal-title":"Plast Reconstr Surg"},{"key":"R10-20250502","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1097\/SAP.0000000000000553","article-title":"Management of a common breast augmentation complication: Treatment of the double-bubble deformity with fat grafting.","volume":"76","author":"Bresnick","year":"2016","journal-title":"Ann Plast Surg"},{"key":"R11-20250502","doi-asserted-by":"crossref","first-page":"1434","DOI":"10.1097\/01.prs.0000434405.91316.96","article-title":"The double-bubble deformity: Cause, prevention, and treatment.","volume":"132","author":"Handel","year":"2013","journal-title":"Plast Reconstr Surg"},{"key":"R12-20250502","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1007\/s00266-017-0854-7","article-title":"The inframammary fold (IMF): A poorly appreciated landmark in prosthetic\/alloplastic breast aesthetic and reconstructive surgery. Personal experience.","volume":"41","author":"Atiyeh","year":"2017","journal-title":"Aesthetic Plast Surg"},{"key":"R13-20250502","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1007\/s00266-017-0918-8","article-title":"Staying out of double-bubble and bottoming-out deformities in dual-plane breast augmentation: Anatomical and clinical study.","volume":"41","author":"Salgarello","year":"2017","journal-title":"Aesthetic Plast Surg"},{"key":"R14-20250502","doi-asserted-by":"crossref","first-page":"e1411","DOI":"10.1097\/GOX.0000000000001411","article-title":"The supra-inframammary fold approach to breast augmentation: Avoiding a double bubble.","volume":"5","author":"Swanson","year":"2017","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"R15-20250502","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1093\/asj\/sjv174","article-title":"Asymmetry of inframammary folds in patients undergoing augmentation mammaplasty.","volume":"36","author":"Yeslev","year":"2016","journal-title":"Aesthet Surg J"},{"key":"R16-20250502","doi-asserted-by":"crossref","first-page":"NP313","DOI":"10.1093\/asj\/sjw103","article-title":"Can we really control the inframammary fold (IMF) in breast augmentation?","volume":"36","author":"Swanson","year":"2016","journal-title":"Aesthet Surg J"}],"container-title":["Plastic &amp; Reconstructive Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/PRS.0000000000008563","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T02:00:33Z","timestamp":1746151233000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/PRS.0000000000008563"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,13]]},"references-count":14,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.1097\/prs.0000000000008563","relation":{},"ISSN":["0032-1052"],"issn-type":[{"value":"0032-1052","type":"print"}],"subject":[],"published":{"date-parts":[[2021,10,13]]}}}