Optimal Inframammary Fold Incision Length Based on Implant Volume for Breast Enlargement: A Cadaveric Study

Purpose: Breast augmentation is the most commonly performed aesthetic operation in the Unites States annually. With the increasing popularity of gel implants, optimal incisional length for specific implant volumes becomes a factor to consider. Our study is the first, to date, to measure optimal incisional length for increasing Mentor smooth, round, moderate plus silicone implant volumes. Method: Three cadaver breasts were dissected in our anatomy laboratory. After dissection of a subpectoral pocket via an inframammary fold incision, time of implant insertion was measured for increasing volumes with the use of increasing incisional site lengths. Results: Values for increased incisions are as follows: 2.5-cm incision facilitated 100-cm³ implant (average time [AvgT] 76 seconds); 3-cm incision 100-cm³ implant (AvgT 32 seconds), 200 cm³ (AvgT 84.33 seconds); 3.5-cm incision 100-cm³ implant (AvgT 13.00 seconds), 200 cm³ (AvgT 22.00 seconds), 300 cm³ (AvgT 33.67 seconds); 4-cm incision 100-cm³ implant (AvgT 5.67 seconds), 200 cm³ (AvgT 11.33 seconds), 300 cm³ (AvgT 21.33 seconds), 400 cm³ (AvgT 26 seconds); 4.5-cm incision 100-cm³ implant (AvgT 5 seconds), 200 cm³ (AvgT 15.17 seconds), 300 cm³ (AvgT 19.67 seconds), 400 cm³ (AvgT 26 seconds), 500 cm³ (AvgT 39.67 seconds), 600 cm³ (AvgT 59.33 seconds), 700 cm³ (AvgT 78.67 seconds); 5-cm incision 100-cm³ implant (AvgT 1 second), 200 cm³ (AvgT 3.67 seconds), 300 cm³ (AvgT 8 seconds), 400 cm³ (AvgT 13 seconds), 500 cm³ (AvgT 19.33 seconds), 600 cm³ (AvgT 23.33 seconds), 700 cm³ (AvgT 28 seconds), 800 cm³ (AvgT 33 seconds). Conclusion: Based on our results, the optimal incision size for increasing Mentor smooth, round, moderate plus volumes is as follows: 2.5 cm for 100-cm³ implant, 3 cm for 200-cm³ implant, 3.5 cm for 300-cm³ implant, 4 cm for 400-cm³ implant, 4.5 cm for 500- to 700-cm³ implant, and 5 cm for 800-cm³ implant. This guideline can be used to provide the most aesthetic results without tissue compromise.