Breast reconstruction and cosmetic augmentation rely on the anatomy of the inframammary fold and pectoralis major origin. There is continued debate as to whether the pectoralis origin should be released in augmentation procedures. No study to date has determined the anatomic relationship between these two intimate locations. The anatomy of the fold has been previously defined histologically. The anatomy of the pectoralis origin has also been identified. The relationship between these two anatomic landmarks which are routinely dissected during aesthetic breast surgery remains undefined. In order to identify the specific relationship, four female and four male cadavers were dissected. Methylene blue was injected perpendicular to the superficial skin fold in order to stain its location along the rib cage. The dissection was then performed along the breast meridian. In all cases, the skin fold was located either one rib or one intercostal space below the pectoralis origin. This data indicates that the pectoralis origin at the breast meridian needs to be released in augmentation in order for implants to fill the breast envelope down to the inframammary fold, thus avoiding excessive upper pole fullness. Living subjects undergoing breast procedures such as mastectomy and augmentation are currently being studied.