Breast Augmentation: Incision Decision

Getting a breast augmentation typically means getting breast implants. These implants will either be filled with a saline-solution or silicone-gel and inserted through an incision.

Interesting fact: soy oil and polypropylene string used to also be used as implant fillers; for various reasons these types of implants are no longer manufactured.

There are five different types of surgical incisions for the emplacement of breast implants:

  1. Inframammary: an incision made below the breast, in the inframammary fold (often referred to as an IMF incision). Dr. Elluru prefers this incision location for many of the silicone-gel implant breast augmentations he performs. The benefits of this location are: the scar is easily hidden in the crease of the breast fold and it allows the greatest access for a precise cut and emplacement of the breast implants.
  2. Periareolar: an incision made along the bottom half of the areola’s circumference. Aesthetically this is a great approach because the incisions are at the areolas’ border and therefore scars tend to be almost imperceptible. While this is a good approach, periareolar incisions do have a slight increase in the potential for post-operative functional issues. These issues could include altering the sensitivity of the nipples, a lessened ability to breast feed, and a slight incidence of capsular contraction. However, it’s important to note that this is a successful incision site without issues for many.
  3. Transaxillary: an incision made to the armpit. This allows the surgeon to place the implants without producing visible scars on the breast. One downside to the armpit incision is that it is more likely to produce asymmetry of the implants’ position. Also, if any revision is necessary a second incision will have to be made - usually an IMF or periareolar - resulting in those scars as well.
  4. Transumbilical: an incision made at the navel (often referred to as a TUBA incision). Like the armpit incisions, this approach allows emplacing the implants without visible scares on the breast. However, it cannot be used for silicone-gel implants and makes emplacement of saline implants more technically difficult.
  5. Transabdominal: through an incision made in stomach during an abdominoplasty (tummy tuck), this uncommon incision is referred to as a TABA incision.

While every plastic surgeon may be able to perform a breast augmentation using any of these incisions, each surgeon will have an incision preference-and therefore, more experience with that technique and it’s outcome. Like Dr. Elluru, any plastic surgeon worth his or her salt, will help guide you on which incision will suite your body type and goals best under his or her care.

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