Does going through the areola for breast augmentation cause any long term problems such as problems with mammograms or cancer? Does a donut lift with small implants on someone 36 D that wants fuller breasts sound right?
Long-term Problems from Peri-areolar Breast Augmentation Technique?
Doctor Answers (11)
Areola incision and implants
The periareolar incision is a great way to place implants for the right patient. It provides direct access for visualization of the pocket and the scar camouflages nicely.
Periareolar Mastopexy Concerns
I am not aware of any breast surgery that will cause cancer (cosmetic or reconstructive). Breast surgery can alter mammograms, but radiologists seem to be attuned the differences between surgery related changes and signs of cancer.
A periareolar mastopexy is best when your only goal is to move the nipple a little higher on the breast without changing the breast. It is also good when combined with an implant for a smaller breast with very little laxity. It can help correct a condition known as tubular breast deformity. It can reduce the size of an overly large areola.
When limiting the incision to the edge of the areola, there is not much tightening of the loose breast that can be accomplished. Breast tissue and skin that hangs below your inframammary fold (the under-breast fold) may not be improved much. This is more of a concern when your breast is as large as a D-cup already. If your breast glandular tissue is rather firm, you have the best chance of success.
The periareolar incision is a very good incision. All incisions have their advantages and disadvantages. This is something that your board certified plastic surgeon can discuss with you. Periareolar lifts are generally better when small implants are placed. Otherwise, the breast assumes a flattened appearance. Also, watch out for scar widening with a periareolar lift. Good luck!
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Periareolar lifts are only good for minor changes.
Periareolar incisions are great for breast augmentation and have no long term problems that you are inquiring about. Periareolar lifts are only good for very minimal changes to the breast. It is a mistake to eliminate the vertical incision with breast lifts. The vertical component is very important in the shaping of the breast.
Periareolar lifts have breast shaping limitations
There are no safety issues associated with periareolar lifts. For the right patient, it is a very nice way to place an implant and give a slight lift to the breast. This technique can be overused in an effort to avoid the vertical and anchor scars from more formal lifts. In a patient who has enough lax skin (ie a D cup patient like yourself) a periareolar lift can end up with a flat baggy breast with an enlarged areola with a poor scar around it. Hopefully you are going to a Board Certified plastic surgeon who can examine you and tell you what would be best for your body.
A donut lift will not lift a D cup
A well done areolar incision heals very well. There are some down sides to any incision used to place a breast implant so make sure you review each incision with your doctor.
As far as the "lift" is concerned, I would be concerned that a small implant and a donut lift may not accomplish your goals. If the implant is small , it will not add upper pole fullness. If it is large it will likely make you too large. Finally, a donut lift usually works best in smaller breasts, or when minimal lift is needed. My experience in trying to stretch the technique to larger breasts for a real lift has been disappointing from a shape and a scar standpoint.
View results of patients who were D cups and had donut lifts by your doctor. If those results are what you are after then go ahead. We have done a rare patient with those parameters, but only when they have viewed multiple photos, rejected other options and are comfortable with the results I showed them.
Peri-areolar technique is very safe.
Hi! I use the "doughnut" lift with small implants all the time. But if you are a D cup already, a better choice for you might be a good INTERNAL lift that will give you long term upper fullness, without implants. The key is not to rely on pulling the skin. The downside of this approach is that you usually need a "lollypop" scar.
Incision wont cause disease.
The periareolar incision is commonly used in lifts and reductions, and does not cause any disease. Sensation to the nipple may be injured however.
In my experience, I do not like the donut mastopexy, as the amount of lift is limited, the ability to shape the breast is limited, and worst of all, the areola tends to enlarge and be un-aesthetic. Again my opinion on that
Regarding the implant size, I base that decision in close consultation with the patient, and base that decision on patient goals AND the diameter of the implant. That said, I can't give you an answer as to the appropriateness of the size of the implant you mention.
Periareolar a versatile choice
There is ongoing confusion about the pro's and con's of the periareolar incision. Some mistakenly call it "through the nipple" which it is not. The scar hides very well along the edge of the areola where the skin changes color. It is not necessary however to go through the breast tissue, so there should be minimal disruption to mammograms if it is done that way. It is also very good access for making the space for the implant as well as any reoperations that may be necessary. (Unlike for example the axillary incision.)
The most recent large studies have found no difference in the risk of sensation change to the nipple with the periareolar incision as compared to the other options.
A strictly periareolar incision to place a breast implant usually heals well. If you look very closely at areolar shape, however, even in the very best of hands, you will often find a reduction in the nipple-to-bottom of areolar distance in patients, and sometimes a slight downward cant of the nipple. Incisions tighten, after all, and exert traction on the nipple. That effect is minimized if a periareolar incision is made.
SInce breast implants must statistically be redone in 10-15 years, if the periareolar incision is reused, this type of deformity typically increases; more scar tissue, more artifact.
Nipple sensitivity and the ability to breast feed is probably more affected with periareolar inciisons than with under the breast incisions.
Mammography should not be any different for the different incision types.
Regarding your surgery specifically, are you sure you want to increase your breasts beyond a D cup? That is often the threshold for women to start coming in for breast reductions! No doubt you have spoken to your board certified plastic surgeon about the risks and benefits, and the possibility of various lifts as an alternative to a breast implant in a breast that is already a "D".
Periareolar lifts have as an inherent disadvantage larger areolae, more gathering around the areola, and a less powerful lift than a lollipop or Wise pattern lift.
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.