Breast Augmentation Incisions: Pros and Cons
Dr. Michael Eisemann M.D.
Eisemann Cosmetic Day Surgery Center

Knowing you desire an enlargement is only the beginning of your journey. Among the many things to understand is exactly where the implants should be inserted into your body. There are three common entry points, each with it’s own set of advantages and downsides.

Periareolar

The Periareolar incision is located on the nipple itself. It is one of the most common procedures in breast augmentation. If you are interested in a mastopexy (breast lift), this incision is the choice most surgeons will recommend. It works well with every type of implant and for both over and under the muscle implant placement.

The Periareolar incision is made around the bottom half of the dark circle of skin surrounding the nipple. The exact incision line is critical for a satisfactory result. For the scar to blend properly it must occur exactly on the edge where the lighter skin meets the darker skin. If the incision heals within the areola area, a “smiley face” can occur from the lighter-colored scar tissue. Surgical tape is placed on the incision and should not be moved, as it reduces the effects of gravity pulling on the skin and aids the scar to heal as a flat, very thin line. A properly healed scar from a well-placed periareolar incision is barely visible.

A potential risk factor is the bacteria found in breast ducts, which can spread germs into the area holding the implants. Many surgeons use a protective sleeve to keep the implants from coming in contact with the breast ducts. This sleeve is not useable if the implant chosen is pre-filled, as with certain saline or gel implants, since they cannot be rolled-up and put in place unfilled.

Inframammary Fold

The inframammary incision is as popular as the periareolar. The implant can be placed or removed above or below the muscle. Since the implants do not pass through the breast ducts, the risk of bacterial infection is greatly reduced. This incision is a favorite among surgeons because it gives the surgeon a great deal of control over the placement of the implant.

The incision is made just above the crease, or inframammary fold, underneath the breast. This helps prevent the scar being seen when in a swimsuit or lingerie. Proper placement is an art-form in itself; the surgeon must estimate where the incision will sit in relation to the crease created by the larger, enhanced breast. A wrong placement higher or lower on the breast will make the incision visible.

Article Courtesy of Michael L. Eisemann, M.D., F.A.C.S., a Houston Breast Augmentation Surgeon

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