A NEW STRATEGY TO DEFINE THE INFRAMAMMARY FOLD IN REVISION BREAST SURGERY: THE HYDRANGEA TECHNIQUE

Introduction. The inframammary fold (IMF) is considered an anatomical landmark of remarkable importance. It is essential to preserve its features for ensuring an optimal aesthetic result on procedures with either cosmetic or reconstructive purposes. Interventions such as mastectomies, breast augmentation or mastopexy can alter the IMF resulting in an unsatisfactory aesthetic result. Various techniques have been developed to address IMF malposition. This manuscript illustrates a new surgical procedure that we named "Hydrangea Technique". Methods. A 45 y.o. patient with a history of previous breast surgery, resulting in an altered IMF associated with asymmetry, was evaluated. We therefore applied our proposed technique that consists of the use of transcutaneous sutures combined with polyurethane foam in order to restore the IMF and achieve an optimal aesthetic result. A follow-up was conducted 10 months postoperatively to evaluate the aesthetic outcomes. Results. The procedure led to a well-shaped IMF and a satisfactory breast symmetry. We did not observed any complications, such as pressure injuries, skin maceration or infections. At the 10-months follow- up, we noticed a stable and appreciable aesthetic outcome, with good IMF definition and optimal symmetry. Conclusions. This case report shows that the Hydrangea Technique is an easy and effective method to recreate the IMF after previous breast surgeries, ensuring stable results. However we reported only a single case, resulting in important limitations. Further studies with extended follow-up are needed to validate this technique for larger clinical application.