What approach (incision) is best for me?
This is part three of a five part series on the top questions breast augmentation patients should ask.
By far, most of my patients choose the armpit incision. There is no tension in that area, it is well concealed, usually there is a crease for hiding the scar within, and it is located off the breast (the very part we are aesthetically enhancing). This is also the best approach for a subfascial (to be explained below) placement of an implant.
Areolar approaches are useful in patients who have a very tight skin envelope in the lower pole of the breast or who have tuberous breasts. Tuberous breasts have a very tight envelope and extra protrusion of the areola and nipple because of actual glandular tissue within these structures.
The inframammary approach is helpful for women who choose large silicone implants; however, the use of assistive devices for implant procedures, including the Keller funnel, can allow for very large implants to be placed through rather small incisions in the armpit or areola.
TUBA, or transumbilical breast augmentation, is a means by which a saline implant may be placed by way of the belly button. Silicone implants may not be inserted by this route.
For patients who choose breast augmentation with fat grafting, only very small (~2mm) punctures need be made (generally in the armpit) to accomplish the result.
Before and after breast augmentation
If a breast lift is to be performed at the same time, we only use the incisions required to give the patient the look they desire. This means that subtle lifts need only and incision on the top semi-circle of the areola (crescent lift). An incision around the areola affords slightly more lift (Benelli procedure). Incrementally, an incision is made vertically, from the areola downward to accomplish a greater lift an rejuvenation of the breast (lollipop, keyhole, or vertical lift). Typically, a scar underneath the breast fold (anchor, or inverted-T) is not required unless the patient needs or desires an extensive lift.
More from our 5 part breast augmentation blog series:
- Read part 1, Top Five Questions for Breast Enhancement
- Read part 2, Do I need a lift?
- Read part 4, Over the muscle or under the muscle?
- Read part 5, Silicone, Saline, or Fat