Breast Augmentation Dallas - Breast Implants Dallas

Breast augmentation is one of the most frequently performed cosmetic surgery procedures in Dallas, Plano, Ft. Worth, Frisco, McKinney, and Allen, Texas.  There are four incisions used for breast augmentation or breast enlargement surgery.   Each incision type has advantages and disadvantages.  The preferred incision depends on patient anatomy and the type of implant used, not to mention patient and surgeon preference.   The different types of incisions utilized are inframammary (below the breast crease), periareolar (around the pigmented skin surrounding the nipple), transaxillary (through the armpit), and transumbilical (through the belly button).

Inframammary Incision

The inframammary incision, which is made in the natural crease under the breast, is a commonly used incision for breast augmentation.  In women who have a well-formed crease, this is a well-camouflaged incision, and, if designed properly, is really only visible when lying horizontally.  The incision allows for the placement of both silicone breast implants and saline breast implants, and allows for placement either in front of or behind the chest wall muscle.  Also, if revisions are required in the future for correction of capsular contracture, breast implant rupture, or breast implant migration, this incision can be used again.  Other incisions often cannot be utilized for revision surgery.

In a woman without a well-formed breast crease, the inframammary incision is not a good choice.  In these women, it is possible for the incision to ride too high, and become visible on the lower pole of the breast.

Periareolar Incision

The periareolar incision is also a commonly utilized incision for breast augmentation.  The periareolar incision is made around the pigmented skin which surrounds the nipple.  The incision is made along the edge, where the lighter breast skin meets the areola, so that the incision blends in nicely.  Like the inframammary incision, the periareolar incision allows for placement of both silicone breast implants and saline breast implants, as well as placement either in front of or behind the chest wall muscle. Also, like the inframammary incision, the periareolar incision can usually be utilized for future breast revision surgery. If a patient requires a breast lift at the same time as breast augmentation, this incision will usually be used, since both types of procedure utilize this incision.

A small minority of patients have poor scarring after the periareolar incision is used.  If the incision does not heal well, the scar can be noticeable, as it is located in the center of the breast.  In addition, the potential loss of sensation to the nipple is slightly higher with this incision compared to other incision types.

Transaxillary Incision

The transaxillary incision is in the armpit, so no incisions are visible on the breast.  It is possible to see the transaxillary scars when the arms are lifted, but the incisions are typically very well hidden.  The surgeon usually uses a fiberoptic camera (endoscope) to guide the implants into their proper position.  Like the inframammary and periareolar incision, the transaxillary incision allows placement of breast implants in front of and behind the chest wall muscle.

A big drawback of the transaxillary incision is that it cannot be used effectively for revision surgery.  If a patient develops capsular contracture, breast implant rupture, or breast implant migration, she would likely require either an inframammary incision or a periareolar incision in the future to correct this.  In addition, given the greater distance of the incision from the breast implant pocket, postoperative asymmetry is slightly more likely to occur, particularly with a plastic surgeon with less experience in this technique. Another disadvantage is that a significantly larger incision in the armpit is required for placement of silicone breast implants; for that reason, most plastic surgeons do not use this incision for placement of silicone breast implants.

Transumbilical incision
The least commonly-utilized incision is Trans-Umbilical Breast Augmentation (T.U.B.A.), where an incision is made in the navel to place a saline breast implant.  The major advantage of this incision is the small, virtually undetectable incision within the belly button.

With the growing popularity of silicone breast implants, though, this incision is becoming less popular, as only saline implants can be placed through this approach.  In addition, placement of breast implants through the navel involves a relatively blind approach – the surgeon does not see the pocket in which the implant is placed as well as with other incisions.  For that reason, asymmetry tends to be more common with this incision than other incisions utilized.  Another disadvantage is that this incision cannot be utilized for any revision surgery, meaning that an additional incision would need to be made on the breast for this purpose.  A rare complication of this technique of the creation of permanent track marks extending from the belly button to the breasts.

Ultimately, the best incision for breast augmentation varies from patient to patient.  It’s a highly personal decision that is best made after a thorough consultation with an experienced, board-certified plastic surgeon.