Breast Augmentation Characteristics
The seven characteristics that go into breast augmentation
The fifth point to discuss is incision placement. By now you can guess I have strong feelings about this as well. We’ll talk about only simple augmentations and not implant augmentation combined with breast lift. Essentially there are four options,infra-mammary fold approach, peri-areola approach, trans-axillary approach, and trans-umbilical approach.
The new device known as the Keller funnel has allowed pre filled silicone implants to be placed now with incisions nearly the same size as those used for saline filled implants which are unfilled or partially filled when placed. See my you tube video ” Implant Magic” to see how large pre filled silicone breast implants can be placed thru tiny incisions — you’ll love it!
Peri-areola incisions are popular. The problem is that it increases the likelihood of nipple numbness. A bigger problem to me is that the incision goes thru breast tissue and directly down to implant space. I have always had a problem with this. It often triggers a local contracture response which can pucker the breast, tighten and alter the urge of the lower breast and create unsightly shape issues. They are sometimes not completely correctable.
Trans-axillary augmentation sounds great in theory but the problem here is that this incision is the farthest away from the most critical area to precisely dissect internally to release muscle in order to get the best cosmetically shaped and aesthetically appealing breasts. In precision oriented surgery this is a problem. And this is why trans-axillary augmentation notoriously leads to implant malposition most commonly, high and widely positioned breasts and is known to have the highest reoperation rate. Unnatural! And I don’t like it.
Trans-umbilical implant placement is a gimmicky approach used in marketing. Did you know that manufacturers will not warranty their implants placed that way? Interesting.
It is virtually impossible to get an anatomically correct sub muscular implant placement this way. Essentially all are subglandular and look like half grapefruits. No artistry here. Just because you can doesn’ t mean you should. Not good.
Finally, we get to infra-mammary approach. This allows for precision placement and artistry of implant space creation. It is the most versatile in dealing with the myriad of anatomical nuances our bodies present with. It is by far the best. So I favor this method. Look at my web site. I’ll bet you can’t find a single incision on any view of any breast augment patient!