The Breast Implant Incisions

In a breast augmentation procedure, incision preference is ultimately left up to the woman undergoing the procedure. There are different benefits and drawbacks to each of the four incision options, which should be discussed in detail with your surgeon. Incision preference will also be related to the type of implant that you desire, as some incisions do not allow for the use of certain implants. Incision preference is also tied to the surgeon's level of skill and experience. Most surgeons also have their own incision preference, or one technique they are most comfortable and experienced in performing. If you do not have a strong incision preference, it is probably wisest to go with the technique your surgeon is most confident in and experienced with. Conversely, if you do have a strong incision preference, it is important to find a qualified surgeon who is comfortable and experienced performing the procedure you desire.

There Are Four Different Types Of Incisions That Can Be Made To Achieve Breast Implant Surgery :

The Breast Implant Inframammary Incision

1. Inframammary Incision (Crease & Fold Incision)

The inframammary incision is a very popular surgical option for breast augmentation. The inframammary incision is made in the fold under the breast, making the scar relatively inconspicuous after surgery. Like the periareolar option, the inframammary incision allows for placement of the implants both under the muscle and the glandular tissue. If there are any postoperative complications, the surgeon will typically be able to re-use the inframammary incision without needing to make any additional incisions.

The scar from the inframammary incision is not as conspicuous as the scar from nipple incision. A major benefit of the inframammary option is that women typically experience less difficulty breastfeeding after breast augmentation. The inframammary incision bypasses the milk ducts, posing less risk of damage to those areas. This surgical option also does not require the protective sleeve when placing the implants.

The Breast Implant Peri-areolar Incision

2. Peri-areolar Incision (Nipple Incision)

Periareolar incisions are among the most popular incisions used by surgeons to insert implants during breast augmentation. The periareolar incision is made around the edge of the nipple where it meets the surrounding breast tissue. The scar from a periareolar incision is virtually invisible, as it blends well with the natural change in skin color.

Benefits of Periareolar Incisions

In addition to being the most easily concealed incision, the periareolar option has several other benefits.

  • The periareolar incision allows the surgeon to place implants under the muscle or under the glandular tissue.
  • The periareolar incision also gives the surgeon the greatest degree of precision due to the close proximity of the incision to the treatment site.
  • If there are any subsequent complications after the initial breast augmentation surgery, an additional incision will not typically be required. The surgeon is usually able to go in through the original periareolar incision, eliminating the risk of gaining additional scarring from breast augmentation or corrective surgery.
  • During breast augmentation using the periareolar incision, the implant is rolled up into a protective sleeve before being inserted through the passage into the implant pocket. The protective sleeve prevents the implant from coming into contact with bacteria that could later cause a local infection. The sleeve is removed after the implant is correctly placed.

Risks

On the downside, the periareolar incision is associated with the highest degree of difficulty breastfeeding after surgery. Loss of sensation in the nipple area is also another risk associated with the periareolar incision.

Transaxillary Incision (Transax Or Armpit Incision)

The transaxillary incision is one surgical option that can be used during breast augmentation. The transaxillary incision is made under the arm, so that there are no scars in the breast area. It is possible to see the transaxillary scar when the arms are lifted, but the incisions are placed as inconspicuously as possible to mitigate the visibility of the breast augmentation scar.

Procedure

The Breast Implant Transaxillary Incision

When the transaxillary incision is chosen, the surgeon may conduct the surgery with or without an endoscope. An endoscope is a small surgical camera that allows the surgeon to guide the implants into the proper breast area. During the breast augmentation surgery, the doctor will make the transaxillary incision and cut a channel from the armpit to the breast area.

One potential drawback of the transaxillary incision is the risk of less than perfect placement of the implants. This is because the surgeon is working further away from the actual surgical destination, leaving more possibility for error. When a surgeon is trained and experienced with the transaxillary technique, the risk of error in implant placement is very low.

If there are postoperative complications that require a subsequent surgery, it is generally not possible to reuse the same transaxillary incision. During a corrective surgery, the surgeon will typically have to use the periareolar or inframammary technique, adding another scar from breast augmentation. Some studies have also shown that the transaxillary technique can cause a loss of nipple sensation after surgery.

TUBA Incision (Belly Button, Navel, Or Transumbilical Incision)

The transumbilical breast augmentation technique, also known as the TUBA method, is a less common incision option during this type of cosmetic surgery. During the transumbilical technique the surgeon will make an incision in the patient's belly button or navel in order to insert the implants.

The Breast Implant TUBA Incision

One of the greatest benefits of the transumbilical incision is that there are no scars in the breast area and all other scars are hidden within the belly button area. While it may seem like an extreme surgical option, the transumbilical technique is actually the least invasive of all breast augmentation incisions. Recovery time is also not as great with the transumbilical technique as some other methods.

There are also limitations and drawbacks to the transumbilical technique. A patient who chooses this procedure must receive inflatable implants, since it is not possible to have a pre-filled implant guided through such a small incision into the breast area. If there is a complication with the results and additional surgery is required, the surgeon will not be able to re-use the transumbilical incision and will have to make a periareolar or inframammary incision. The transumbilical technique also has the greatest risk of error because the incision is so far from the actual implant destination.

During the transumbilical technique, the surgeon will make the incision in the belly button area and make a "V" shaped passage from the incision to each breast. In very rare cases, this can actually leave "V" shaped tracks on the patient's stomach area. This is a very uncommon complication of the transumbilical technique. After the passage has made from the transumbilical incision to each breast, the surgeon will use a small surgical camera called an endoscope to guide the implants into their pocket. Once the implant is in place, a small tube will be guided in to fill the implant to its predetermined volume. Lastly, the transumbilical incision will be closed.

The periareolar and the inframammary incision are most popular, the former being made around the nipple and the latter made within the natural fold of the breast. The transaxillary incision is made in the armpit area. The least common incision preference is the transumbilical incision, where incisions in the bellybutton are used to place the implants.