How to make breast augmentation plastic surgery via periareolar incision?

Perioareolar (nipple) incision with breast implant augmentation

I use the breast augmentation periareolar incision in approximately 50% of cases as it allows some versatility in adjusting the height of uneven areolas.

However, the limitations are thes size of the areola (small ones do not allow placement of larger silicone implants) as well as the concerns for bacterial contamination with biofilm and subsequent capsular contracture (CC).

Having said that, it is my overall impression that the rate of CC is roughly equivalent in my practice and the in range of 5% over a 3 year period (overall 8% in national studies for Baker III/IV). (Otto Joseph Placik, MD, Chicago Plastic Surgeon)

Breast augmentation periareolar vs Inframmary or Transaxillary Incision

Breast augmentation periareolar incision photo

I have never experienced a breast augmentation infection whether using periareolar or transaxillary incisions (my two preferred approaches). The only negative of a periareolar incision is the likelihood that breast feeding will be more difficult to start and/or maintain due to some of the breast ducts being severed. The approach however leaves a consistently small and barely visible incision and the risk of loss of nipple sensation is no higher than with the other approaches.

The risk of capsular contracture seems no higher with any particular incision. My feeling about the inframammary scar is that it should usually be avoided. I have seen a small proportion of patients with that incision show minimally visible and acceptable scars, however I have seen a lot of patients with light/dark/raised or depressed scars that they regret having. Others will disagree, however I have been performing breast enlargement surgeries for over 25 years. (Jon A. Perlman, MD, Beverly Hills Plastic Surgeon)

Cc after nipple incision

Breast augmentation periareolar incision scar

The risk of cc is increased with periareolar incisions due to cutting across breast ducts with that approach. Theoretically bacteria in the ducts contribute to cc. Use of inframammary incisions avoids this as you do not violate breast ducts.

Much of this is based on thoery, but I personally cannot say I see more revisions with either approach. (Daniel J. Casper, MD, Los Angeles Plastic Surgeon)

No increase of complications with areolar incision

Breast augmentation periareolar incision photos

I have been using both inframammary and peri-areolar incisions for breast enlargement for over 10 years, and have seen no significant difference in incidence of capsular contracture or infections between both approaches.

The areolar approach delivers a superior scar to my opinion, and also allows the surgeon better 360 degrees access to the pocket. It is my preferred approach. (Alexis Verpaele, MD, Belgium Plastic Surgeon)

Breast implants through a periareolar incision has benefits

Breast augmentation periareolar incision recovery

Comparing breast implant incisions can be difficult and each has its champions, though we tend to like the periareolar incision very much. We have used the breast augmentation periareolar incision for over 25 years and find that with care the incision is much more difficult to see, and more easily concealed than the inframammary, or under the breast approach. The periareolar incision does not affect nipple sensation any more than other approaches, does not impact breast feeding, and does not lead to any revisions. Capsule contracture rates are not affected by this approach or we would have long ago stopped using it. Next time you are in your bikini top with your arms stretched overhead, think of where your scars will be. (Peter E. Johnson, MD, Denver Plastic Surgeon)