Breast Implant Entry Location
Going in for breast augmentation surgery? The good news is, unlike other surgeries, you've a choice of the incision site…if that's any consolation! However, there are some distinct advantages and disadvantages in selecting the various incision sites for breast implants.
The surgical incision sites
Your anatomy, the type of implant, the technique used and the implant's final destination, all have a bearing on the location of the incision. Typically, a saline breast implant is inserted empty and then filled with saline, whereas most of the pre-filled silicone gel or cohesive gel implants are inserted through the crease under the breast or from the area around the nipple.
If you're serious about this surgery, you'd probably already have an idea where you'd like to have the incision. However, discuss all the pros and cons of the specific incision site with your surgeon and let them have the last word on it. Rest assured your surgeon will give you the smallest incision, keeping your body aesthetics in mind!
The four areas where an incision can be made and breast implant inserted are the armpit, areola, breast crease and the navel. Medically, these locations are termed as transaxillary, periareolar, inframammary and transumbilical, respectively. Let's see each one individually:
a. Periareolar(around the nipple): The cut is made in a semi-circle around the lower part of the areola, the dark area around the nipple, basically to hide the scar. This technique gives the flexibility to place the implant either above or below the muscle. If you're worrying that a periareolar incision will damage the milk ducts and glands or the nipples will lose sensation, your fears are not totally unjustified. Difficulties in breast feeding and loss of sensation have been known to occur. However, in the hands of a qualified and experienced plastic surgeon, these risks are minimized. On the positive side, this incision conceals the scar the best amongst all other sites. However, only inflatable implants, like saline implants, are used in this procedure.
b.Transaxillary (armpit): In this, a two to four centimeters long incision is made in the skin folds of the armpit. This incision helps in placing the implant below the muscle. A tiny lighted camera, called the endoscope, is sometimes used for making the pocket for the implant. Although, the scar in this is less concealed than periareolar incision, there’s no hindrance to breast feeding. However, there’s an increased chance of bleeding or bruising. However, this incision is not recommended, if you’re going in for breast augmentation because of sagging or ptotic breasts.
c. Inframammary (breast crease): This incision is situated in the inframammary fold, also known as the crease underneath the breast. In this, a four to five centimeter incision is usually made just above the crease of the breast, where the breast meets the chest. This technique gives the flexibility of either placing the implant above or below the muscle. It’s most commonly used for inserting silicone implants. Although, the incision is less concealed than the periareolar incision, it too doesn’t hinder in breast-feeding. However, in this too, there’s an increased chance of bleeding or bruising. This incision is ideal for first-time surgeries and revisions.
d. Umbilical or endoscopic incision (navel): This incision site is the newest technique, but not too popular. The incision is made at the rim of the belly button to make a tunnel through subcutaneous tissue, leading to the loose breast tissue. The procedure may be assisted by an endoscope. In this too, the implant can be placed either above or below the muscle. Since, this incision results in a single hidden scar, it doesn’t hinder in breastfeeding. Only inflatable implants are used in this procedure.
If you know the pros and cons of the various incisions, you’d be that well prepared to arrive at the correct decision in consultation with your surgeon.
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