Breast Augmentation

Breast Implant Incisions

Breast Implants have traditionally been inserted into the implant pocket via three incisions: axillary, peri-areolar, and inframammry fold. The axillary (armpit) incision is considered by many surgeons to be more technically difficult than the other two incisions since the incision site is located farther from where the implant pocket is to be created and the surgical disection may require the use of an endoscope. This had led to a higher incidence amongst many breast augnmentation surgeons of some degree of asymmetry between the two breasts in the final result. Quite a few breast augmentation surgeons have abandoned this technique for this reason. Furthermore, the proposed advantage of the axillary incision which is that no incisions and therefore no scars are left on the breast can sometimes be negated by the discomfort that some women feel about having potentially visible scars on both armpits which can be seen by the public when wearing sleeveless dress and shirts. There is also an increased theoretical risk of infection of the breast augmentation procedure when using the axillary incision since the breast implant makes contact with the axillary skin which may harbor invisible germs even after a full surgical antiseptic cleaning of the area
The peri-areolar incision is made at the border of the areola and breast skin from aroun the 3 o'clock to the 9 o'clock positions along the areola. When using pre-filled gel implants, many women have areolas that are simply too small in circumference to allow for use of this incision. The breast implants cannot be inserted through this incision without putting undue stress on the areolar skin which can traumatize the area and lead to sub-optimal scarring. This incision also carries the highest risk of permanent loss of nipple sensitivity and breast feeding issues. The inframammry fold incision is made at the base of the breast and is by far the most popular incision since it makes the breast implants surgery technically more easy to perform perfectly, and carries negligible risk of nipple desensitization or breast feeding issues. In general, pre-filled breast implants (gel) will require an incision that is slightly longer than the incision used for saline breast implants which are filled once the implant has already been inserted into the breast implant pocket.