Will Areola Incision Damage Milk Ducts?

My doctor seems to have a preference for the Areola incision due to its scar visibility, and he would use the Keller Tube to make it a smaller incision. However, I am younger and still want to breast feed my future children. Will an Areola incision pose a higher risk to damaging milk ducts or nerves than an infra mammary incision?

Doctor Answers (16)

Periareolar Incision for Breast Augmentation with a Keller Funnel

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This is a good question as the majority of patient that wish to have a breast augmentation desire a result that is going to feel and look natural without having obvious scars.

There are several ways to place the incision so that it is well hidden in natural skin folds or breast transitions.
  • 1.Periareolar
    • a.Hidden at the natural transition from the areola and the breast skin. The incision can be hidden in this natural color transition
  • 2.Inframmary Fold
    • a.The incision is hidden in the fold below the breast.
  • 3.Axilla
    • a.The incision for the implant can be hidden in one of the natural axilla folds. I do these with the aid of scope which allows precise placement of the implant.
    • b.Also the use of the Keller funnel has allowed the placement of larger silicone implants through the axilla.

No one incision is best for every patient and the majority of patients can have the implant placed through any of the three incisions listed above. When do correctly all three of the incisions are well hidden.

The incision at the border of the areola typically does not affect the ducts as the nipple stay completely attached. I do agree with your surgeon that the Keller Funnel allows for the implant to be placed through a smaller incision and less traumatically.

It is important to see your board certified plastic surgeon to help guide you to an implant that will give you an aesthetically pleasing breast.


Miami Plastic Surgeon
5.0 out of 5 stars 19 reviews

Breast Enhancement Surgery

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Good question, one of the downsides of areola incisions is incresed risk of nipple sensitivty issues adn incresed risk of interfereing with breast feeding 

Ryan Neinstein, MD, FRCSC
New York Plastic Surgeon
5.0 out of 5 stars 42 reviews

Will Areola Incision Damage Milk Ducts?

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I believe you should go with the periareolar incision as your surgeon suggests. I believe you should go with the technique that your surgeon is most comfortable with performing. Both surgical approaches and both surgeries have a risk of milk duct transection and therefore, decreased ability to breast-feed. In addition, there is not just one breast duct in the female breast. In the average female breast, there are anywhere between 13 and 25 or more breast ducts. The milk ducts are most concentrated around the nipple areolar complex. Typically, an incision around the nipple areolar complex does transect some, but not all of the ducts. I believe performing a nipple areolar complex incision and placing implants underneath the muscle would still allow you to breast-feed your future children. Sensitivity should remain intact even with the nipple areolar complex incision.

J. Timothy Katzen, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 27 reviews

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Areolar incision for breast augmentation

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The areolar incision often results in a beautiful scar. But the scars with other approaches can also be equally good. I believe that the scars from each of the 3 traditional approaches can all be great if done well. My personal opinion is that the inframammary incision offers the lowest risk of contamination and (for me) the best exposure and control of the implant pocket. I believe that the capsular contracture rate is slightly higher when using the areolar approach. With that said, I think that the areolar incision can be used with little risk of affecting your ability to breast feed. The risk of nerve injury is also quite low with either of the approaches. In the end, you need to be comfortable with your surgeon and your surgeon needs to be comfortable with the specifics of the procedure that he is using. 

William T. Stoeckel, MD
Raleigh-Durham Plastic Surgeon
5.0 out of 5 stars 44 reviews

Will Areola Incision Damage Milk Ducts?

+1

When an incision is made around the areola, the breast tissue is then cut through until the area where the pocket will be made is encountered.  So, yes, the breast tissue is cut, and the breast ducts are within the breast tissue.  Not all ducts are cut, but some in-evitably are.  When an incision is made under the breast or in the axilla, the breast tissue is not cut.  I would discuss your concerns with your doctor, and decide on which approach will be best for you in light of the fact that breast feeding is important for you.  Good luck!

Amy T. Bandy, DO, FACS
Newport Beach Plastic Surgeon
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Areolar versus inframammary incision

+1

Recent studies have found that the areolar incision, while having a nice scar, actually does have a higher risk of complications compared to the inframammary incision - such as capsular contracture, nerve injury and chronic breast pain.  Discuss this with your surgeon and make the choice that is right for you once you understand the risks and trade-offs.

Thomas Fiala, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 33 reviews

Breast Feeding after Breast Augmentation

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You should still be able to breast feed after a periareolar incision breast augmentation if performed correctly. Your breasts may change shape after a pregnancy from getting larger and then shrinking.

Michael Horn, MD
Chicago Plastic Surgeon
4.5 out of 5 stars 25 reviews

Will Areola Incision Damage Milk Ducts?

+1

The milk ducts enter the nipple from the interior of the breasts,therefore the circumareolar does not affect the milk ducts if correctly performed

I use a nipple shield to prevent bacterial contamination frome the nipple

Hilton Becker, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 6 reviews

Injury Of Milk Ducts With Periareolar Incision

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Typically a periareolar incision will not preclude the ability to breast feed. Having said that, I favor an inframammary approach as there is a question of increased capsular contractures with the periareolar incision secondary to bacterial contamination from the ducts.

I hope this helps. Best of luck.

Pedro M. Soler, Jr., MD
Tampa Plastic Surgeon
5.0 out of 5 stars 7 reviews

Choice of incision

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Hi,

all good answers from my colleagues. I agree with Dr. Squires: i have returned to the IMF incision under the breast and found a dramatic reduction in the rate of capsular contracture. Lot's of recent evidence points to possible bacterial contamination and the biofilm created by them that leads to a capsular contracture. 

 

Bennett Yang, MD
Rockville Plastic Surgeon
5.0 out of 5 stars 8 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.