21 Oct 2012

Breast Augmentation: Incision location (part 4 of 7)

Beautiful results from breast implant surgery results from excellent surgical technique, but it also relies on informed decisions by our patients. One decision you must make is the location of the incision for insertion of the implant.
Incisions on the edge of the areola or across the areola (Pitanguy) are worth of consideration, but have the disadvantage of damaging milk ducts, exposing the implant to duct bacteria, and compromising nipple sensation.  Also, a bad scar here is a rare but conspicuous problem.

Patients with very small breasts and no infra-mammary fold are good candidates for an armpit (axillary) incision.  The scar from this surgery is invisible, but does not allow for use of anatomic or textured implants- only smooth, round silicone or saline implants.  This is a favourite for young, A-cup patients, as an incision under the breast (infra-mammary) may remain visible as the breast may not fall over the scar to hide it, and young patients more commonly have thick scars.

The infra-mammary incision is certainly the most versatile, and is our first choice when the scar is not expected to be an overwhelming problem.

Umbilical (belly button) incisions have been described, but offer no advantage over the armpit incision and are rarely performed today.

Yes, many patients at our Toronto cosmetic plastic surgery practice leave the decision of incision location to us, but your participation in the surgical plan may help you obtain a result that is perfect for you.

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Michael Kreidstein, MD, MSc, FRCS(C)

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