12 Oct Transaxillary, Inframammary Or Areolar: Understanding Incisions For Breast Augmentation
An Overlooked Factor In Breast Augmentation
Breast augmentation remains in the top 5 cosmetic surgical procedures in America. With this surgery, special implants are added to enhance the size and fullness of a woman’s breast. Size and fullness are just 2 of several decisions both patient and surgeon make before the procedure. Yet, an often-overlooked factor is the location of the incision. Incision location can decide the overall satisfaction and outcome of the augmentation.
Why incision type matters
Most women thinking about breast augmentation want to improve the breast’s look, size, and shape. A natural concern these patients will have is the degree of scarring after the procedure. To complete the surgery, the plastic surgeon needs to make an incision on or near the breast. The implant material is then outfitted through that cut. Scarring, bleeding, the precision of surgery, and even success rate can be affected by the type of incision. The 3 most common types are transaxillary, inframammary, and areolar incisions.
At the pit with transaxillary
Transaxillary incisions are made in the natural fold on the armpit. From the armpit, the surgeon makes a channel connecting to the breast. The implant is then placed in a pocket created behind the breast. With transaxillary implants, the surgeon can use smaller incisions with endoscopy. This is a narrow tool with a light and camera attached with projects an image on an external monitor.
Pros and cons of transaxillary procedures
Transaxillary is best for women who breastfeed or plan to breastfeed. There is little to no damage to the mammary gland. There will also be no scar on the breast since the spot will be well hidden at the armpit. However, the incision reduces the ability to position the implant in the popular dual plane position. If a future revision is necessary, the surgeon will need a new entry point, creating a second scar.
Going under the breast
Inframammary incisions are under the breast, in the fold between the breast and the chest wall. This incision type allows the plastic surgeon to install the implant with precision and control any bleeding during the surgery. The surgeon may use a larger incision and can place the implant behind the chest muscle. Inframammary incisions continue to be the go-to step for surgeons today.
Why choose an inframammary incision?
The incision gives surgeons control over symmetry, bleeding, and the size of the implant. Like transaxillary implants, there is minimal impact on the mammary glands. Surgeons can also hide the scar easily under the breast or in a bra. If needed, the surgeon can reopen the incision site if necessary. In the future, however, adjusting the size of the breast comes with the risk of exposing the scar. Also, the inframammary incision is challenging for women with small breasts.
Around the nipple
Areolar or periareolar incisions are made at the outer portion of the areola. The surgeon cuts along the line that separates the nipple from the rest of the breast. The scars brought by areolar incisions camouflage with the color of the areola and are barely noticeable. From this location, the surgeon can easily control bleeding and reduce infections. Areolar incisions allow for better precision and are reusable if necessary. However, there is also a greater chance of damaging the mammary glands and an altered nipple sensation.
Make an informed decision
The incision will determine the type of scarring, positioning of the implant, and even future procedures. The surgeon will choose the right location for each patient based on preferences. Find a plastic surgeon that can perform multiple incisions as this speaks to competency. Weigh the pros, cons, and choose the incision that will bring the desired look.