For women who have chosen to undergo a breast augmentation cosmetic surgical procedure, there may seem to be an endless number of choices to be made, from silicone versus saline implants, to implant size and profile, to placement in front or behind the pectoral muscle, to the incisional approach. These are all very important decisions that will affect not only the outcome of the procedure, but breast appearance and subsequent patient satisfaction. During the consultation, Dr. Vincent Marin will carefully go over all the options with patients, including which incision technique will be used to perform the implant procedure. The approach that is used for the procedure can affect implant placement, severity of scarring, and future ability to breastfeed.
Four Approaches to Breast Augmentation
There are four basic incision approaches to the breast augmentation procedure.
- Transaxillary: This technique involves a small incision in the armpit. Saline implants may be used with this approach, which are filled after placement in the breast. Smaller silicone implants may also be placed via the transaxillary incision.
- Periareolar: This approach involves a small incision around the areola (the darkened breast skin around the nipple). While this results in the most minimal scarring, there is a greater risk for loss of nipple sensation.
- Transumbilical: This approach goes through an incision in the belly button. It can only be used with saline implants, which are filled after they are placed. Like the periareolar approach, the periumbilical approach results in minimal scarring. However, it is more difficult for the surgeon to accurately place the implants.
- Inframammary: This is the most popular approach, and places the implant through an incision made at the inframammary fold, where the lower breast meets the chest wall. It can be used with either saline or silicone implants. Its advantages and disadvantages are discussed below.
Disadvantages of the Inframammary Approach
The main disadvantage for the inframammary approach is that it does leave a more noticeable scar than the other approaches. The scar is about 1.5 cm to 5 cm in length. The scar is well hidden in the crease of the breast, and is not usually seen when patients are wearing a bra or bikini top. However, the scar may be visible when patients raise their arms over their head, or when they are lying down.
Advantages of the Inframammary Approach
The biggest advantage of the inframammary approach over the others is that it provides the most direct and visible route for placement of the implant. This means a considerably shorter operation time than with the other approaches, which may also reduce the chance for subsequent infection or hematoma formation. Furthermore, it provides the best means to achieve placement symmetry and, in the case of saline implants, to match the volume amount between the two implants.
Dr. Marin will work with each patient to help them determine which approach best suits their needs and allows for a safe procedure and a quick recovery, with minimal scarring.
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