This is made at the border of the areola, from about the 4 o'clock to 8 o'clock position. It works nicely for patients with larger areolar diameters (4.0 cm or larger), as if often the case after pregnancy and lactation. The color difference between areolar skin and breast skin nicely conceals the scar in most cases, and in many patients the scar is almost undetectable within just a few weeks or months of surgery. This incision truly has the possibility of producing a scar that is ultimately invisible or almost invisible.
A theoretical downside with this incision is that it by definition requires the division of milk ducts when the breast tissue is dissected down to the pectoralis major muscle, and this may interfere with future attempts at breast feeding. There are some who believe that this incision carries a higher risk for capsular contracture as bacteria may be present in the milk ducts which could possibly adhere to the implant surface during breast augmentation surgery, which may over time lead to contracture. The latter is a theoretical concern, and it has not been conclusively shown that the peri-areolar approach has a higher rate of capsular contracture than the axillary and inframammary fold approaches. The peri-areolar incision is therefore still frequently used, as the aesthetic outcomes are usually excellent.