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Where is the best area in my breasts for the doctor to cut open for my implants?

Q:

Actually I would like implants but I am wondering where should the doctor cuts so nobody can see, around my nipple or under my breast?

A:

Incision for Breast Augmentation:

Both the incision around the outside of the areola and the one under the breast are excellent incisions. When done properly, either is almost invisible after a while. The problem with the periareola incision is that it is sometimes difficult getting a silicone breast implant through that incision in someone with a small areola. There is never a problem if you select saline breast implants. Discuss the options with your Plastic Surgeon at the time of your consult.

R. T. Buchanan, MD

A:

Placement of the incision for breast augmentation is one of the many options you have to decide. The most common incisions are the periareolar and the inframammary fold incisions.

The inframammary incision is the most direct incision for both above the muscle or below the muscle position of the implant.

S. F. Shureih, MD

A:

Best Incision for Breast Implants -

The optimal implant incision is determined both by the patient and the surgeon. My preference is to do a small inframammary fold incision which is imperceptible within weeks to months and has met lower revision rates in my personal experience of over 20 years and more than 2,000 breast augmentation patients.

R.J. Rohrich, MD

A:

Three incisional approaches are commonly used for breast implant insertion: trans-axillary (underarm area), peri-areolar (from about the 4 to 8 o'clock position of the areolas), and inframammary fold (in or just above the crease below the breasts). No two patients are alike, so it is important to individualize the surgical plan for each patient's individual needs. An advantage of the peri-areolar incision is that the color and skin texture difference between areolar skin and the adjacent breast skin conceals the resulting scar very nicely. In many patients the scar is almost undetectable after only a few weeks. This incision is commonly used in patients who have had one or more pregnancies and have a medium to large areola.

The axillary or underarm area incision is ideal for patients with very youthful-appearing breasts, especially younger women with no history of pregnancy. These patients often have a small areolar diameter, which makes the peri-areolar incision less than ideal, and smaller, perkier breasts - where the inframammary fold (and thus a scar in that location) can be easily seen.

The infra-mammary fold incision works very nicely for patients who do not have a marked color difference between areolar skin and breast skin, and who have adequate fullness in the lower pole of the breasts. As full breasts conceal the infra-mammary fold very well, the scar is usually not visible when standing or sitting upright. Ideally this scar is placed just above the inframammary fold on the lower pole of the breast, so that it faces down and therefore tends to be less noticeable.

Breast implants can be inserted through a limited incision in the belly button area, however there are a number of problems with this approach and it therefore is not widely used. Approaching the surgery from such a remote location does not lend itself to the creation of a precisely-defined implant pocket.

M.M. Law, MD

A:

The inframammary crease breast augmentation incision is well hidden and provides your surgeon with better visualization to place your breast implants accurately. Complication rate is slightly increased when the incision is placed through the areola.

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