Applied anatomy of distal attachment of pectoralis major muscle

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OBJECTIVE

To clarify the anatomical features of distal attachment of pectoralis major muscle (PMM) to the ribs and sternum that may be useful in breast augmentation.

MATERIAL AND METHODS

We analyzed anatomical features of distal attachment of pectoralis major muscle in 50 patients aged 18—70 years without congenital or acquired chest deformities.

RESULTS

In 62% of cases, sternocostal part PMM distally attached to anterior surface of the sternum, the 5th rib and its cartilage. Lateral (abdominal) part of PMM continued downward and medially towards the 6th-7th and even the 8th rib, where it merged with anterior wall of the rectus sheath. In 28% of cases, PMM attached to the 5th and 6th ribs, abdominal part was also differentiated at the level of the 6th, 7th, and 8th ribs. In 10% of cases, PMM attached to the 5th and 6th ribs. However, abdominal part of the muscle caudal to the 6th rib was not detected during CT.

CONCLUSION

We hypothesize that preserving the distal attachment of abdominal part of PMM during breast augmentation can ensure an important anchor point for the implant. This can prevent displacement of implant downward and outward. At the same time, mobilization of PMM attachment from anterior sternal surface is inappropriate due to the risk of symmastia.

Keywords:

pectoralis major muscle

abdominal part of pectoralis major muscle

breast augmentation

implant rotation

Authors:

Zelenin N.V.

”LANTSET” Multi-field Hospital

Manturova N.E.

Pirogov Russian National Research Medical University;
Institute of Plastic Surgery and Cosmetology

SPIN RSCI: 5232-0412
Scopus AuthorID: 55461712100
ORCID: 0000-0003-4281-1947

Received:

29.10.2021

Accepted:

30.11.2021

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