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Breast Implant Surgery - Types of Incisions

Board Certified Plastic Surgeon serving Northern Virginia and Washington DC

Incisions for breast implant procedures fall into two general classifications: Endoscopic and open.

Endoscopic surgery is a technique in which your breast surgeon creates a small incision in a remote location, and performs the surgery using a small camera that projects the image onto a TV screen.

Open surgery is a procedure in which your surgeon makes the incision in the breast area, and performs surgery looking directly at the surgical site rather than on a TV screen.

Breast enhancement procedures are performed using one of the following four types of incision:

Periareolar
Inframammary fold
Transaxillary

You should be able to get the same excellent results no matter which incision you choose. Please do not fret too much over this decision. You and your surgeon will be able to work together to determine what incision seems best for you.

Periareolar

The periareolar incision, also called a nipple incision, is made along the lower half of the line between the skin of the breast and the areola, which is the darker area of skin surrounding the nipple. The periareolar incision is an open surgery technique, so an endoscope is not required.

Advantages of periareolar incisions include the fact that since the incision is placed in an area in which the skin changes color and texture, scarring tends to be obscured. Also, the incision can be reopened and used for additional procedures or adjustments as required in the future. The scar from this incision is covered in clothing.

The primary risk unique to the periareolar incision is the possibility of breast feeding problems in the future (see FAQ). With the implant coming into contact with the lactiferous sinus, or milk glands, there is an increased risk of infection.

Periareolar incisions are suitable for both subglandular and submuscular implant placements.

Inframammary fold

The inframammary fold incision is made in the crease below the breast, so that any subsequent scarring is hidden from view. The surgeon inserts the implant, adjusting it vertically within the breast. The inframammary fold incision is an open surgery technique, so an endoscope is not required.

Advantages of inframammary fold incisions include that, as with the periareolar incisions, the surgeons can insert the implants very precisely due to the proximity of the incision to the breast; and the incisions can be reopened and reused for additional adjustments and procedures. Inframammary fold incisions also present less risk of infection than periareolar incisions, because the surgeon entirely bypasses the milk glands during the procedure. The scar from this incision is covered in clothing.

The primary risk unique to inframammary fold incisions involves cases in which the breast size is increased considerably and the surgeon has to construct a new crease beneath the breast in order to center the nipple on the new breast. Rarely, in such cases, it is possible for the lower breast crease to be misplaced, which may require additional surgery to modify.

Inframammary fold incisions are suitable for both subglandular and submuscular implant placements.

Trans-axillary Incision

The transaxillary incision is made in the underarm, or armpit, area, through which the surgeon inserts the implant through a channel into the breast. A transaxillary incision can be used for either open or endoscopic procedures.

The primary advantage of the transaxillary incision is that it leaves minimal scarring overall, and no scarring to the breast at all.

Risks and drawbacks to transaxillary incisions include that the incision site is fairly remote from the area being worked on, allowing for less flexibility in adjustment to the implants, and the incisions usually cannot be reused for any additional procedures.

Transaxillary incisions are suitable for both subglandular and submuscular implant placements.

If you would like to discuss breast implant options, Dr. Desman is available for a free consultation in Virginia, and he can answer any questions you might have.

Call 703-924-3144 to schedule a free in-office consultation or to set up a free telephone consultation.

Our goal is to provide you with the highest quality cosmetic surgery care in the Northern Virginia and Washington DC region. Dr. Desman is committed to serving you through advanced training, dedication to perfection and unmatched personal care.