Abstract
Background
The inframammary fold (IMF) incision is one of the most widely used surgical approaches for implant-based breast augmentation. While multiple suture techniques have been described for IMF incision closure, there remains no universally accepted optimal strategy. This study aimed to investigate the clinical outcomes of a modified internal fixation suture technique for the IMF in patients undergoing implant-based breast augmentation via the IMF approach.Methods
A retrospective analysis was conducted on the clinical data of 53 patients who underwent primary implant-based breast augmentation via the IMF approach at our institution between January 2024 and June 2025. All patients were treated with the modified IMF internal fixation suture technique: Prior to implant insertion, a prefabricated Scarpa's fascia flap from the inferior wound edge was fixed to the underlying muscular tissue using horizontal mattress sutures to complete IMF internal fixation, followed by layered tension-reducing closure of the incision. Postoperative assessments included implant position, breast aesthetic outcomes, incision scar appearance, and patient satisfaction.Results
All 53 patients were followed up for 6 to 15 months, with a mean follow-up duration of 12 months. Stable implant position without inferior displacement was observed in 50 patients, while 3 patients presented with mild unilateral implant inferior displacement of less than 5 mm, none of which required secondary surgical revision. All patients achieved well-concealed incision scars with no severe postoperative complications, and the overall patient satisfaction rate with breast aesthetic outcomes was 100%.Conclusions
The modified IMF internal fixation suture technique effectively enhances the supportive strength of the IMF, significantly reduces the risk of implant inferior displacement, and achieves favorable incision scar appearance with high patient satisfaction. This technique holds significant promise for widespread clinical implementation in implant-based breast augmentation.Level of evidence iv
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