There are several breast implant techniques to choose from in order to place the implant in the armpit, belly button, inframammary fold or around the areola. Even though breast augmentation surgeons can perform any of these techniques, many surgeons prefer to use one incision type over another. Although there are advantages and disadvantages to each technique, many surgeons choose the periareolar incision due to its advantages.
A periareolar incision is a half circle made at the outer edge of the areola that follows the curve which segregates the darker skin of the nipple from the rest of the breast. The incision point is usually made at the lower edge of the areola in order to hide any scarring. A pocket is created, usually on the lower semi-circle of the areola, either inside the glandular tissue of the breast or underneath the muscle. The implant is rolled into a protective sleeve that is inserted through the incision and then moved into the pocket. The sleeve is then removed and the implant is centered. Saline breast implants are filled after they are placed within the breast. The surgeon can assess the size, symmetry and shape of the breast and adjust as needed. On the other hand, silicone gel implants are pre-filled and sealed by the manufacturer. Therefore, they are simply inserted and positioned. The incision is closed with dissolvable, hidden sutures and the wound is covered with tape or tissue glue and gauze. The patient will also be fitted with a post-surgical sports bra for support.
Since the periareolar incision point is close to the implant location, surgeons can be more precise with the placement of the implant. In addition, bleeding can be easily controlled during the surgery. Since the incision is made on the border of the areola where it is a darker color, and the texture isn’t completely smooth, the scarring is usually well hidden. Patients can expect the scarring to fade in time and eventually appear as a thin, flat line. If a patient needs to have breast surgery in the future to enlarge the breasts or correct an issue, a periareolar incision point can usually be reopened.
Although there are many positive aspects to periareolar incisions for breast implants, there are also a few downsides to this method. This type of incision poses a risk of severing milk ducts and nerves in the nipple which can lead to breastfeeding issues or loss of sensation in the area. In addition, some studies suggest that patients may have a higher risk of developing capsular contracture since the areola and breast tissue contain bacteria. The bacteria can attach to the implants during the implant placement through the areola. Although some women choose the periareolar incision method because it has the benefit of less noticeable scarring, the scar doesn’t heal well in some cases and can appear lighter than the areola. Also, the scar sometimes raises and becomes more apparent. Patients that experience a loss of sensation, or poor scar healing, may not be able to have future breast procedures using the same incision.
Anyone considering breast augmentation should take some time to learn about the different methods as well as their risks and benefits. Prospective patients should weigh all their options first before deciding which type of implant, placement, incision and surgeon is best for them.