Breast Augmentation: Q&A
Ask a QuestionPeriaerolar Incision Risks?
Hi all :) Would you please let me know in your opinion, what is the risk of capsular contracture and bacterial infection for the periaerolar incision, compared to the inframammary fold one? How much higher is it theoretically and practically? Do you experience more revisions with this incision than the inframammary fold one? Your feedback is greatly appreciated, thank you!
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28 Doctor Answers |
Asked by
7080anon
in Washington
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Incision choice in breast augmentation
Infection in breast augmentation is very rare when performed to todays standard of care. Of the two approached, I prefer periareolar as the inframammary if low can show under a bikini and if high is plainly visible in the nude when standing. It is my preference to never place a scar on the breast when elevating the nipple is noot necessary which is why I prefer to perform transaxillary cold-subfascial augmentation. The patient is lifet with a very thin scar in the armpit...
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Periareolar Incision for Breast Augmentation: Risks
The periareolar incision (under the nipple) for breast augmentation and placement of breast implants is not as common as an incision choice as the lower breast fold or infra-mammary fold incision. The incision is curved under the border of the nipple pigment and actually heals very well. There may be a theoretic increased risk of capsular contracture secondary to bacterial contamination of the breast implant because of the close proximity to the nipple ducts, both internal and external....
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Incision choice and risk.
In theory the periareolar incision has a slightly higher risk of contamination from bacteria within the milk ducts of the breast in comparison with the inframammary incision. However, with appropriate surgical technique, adequate irrigation of both the pocket and the incision, and the use of antibiotics this theoretical risk does not appear to be a large influence from a practical standpoint. The inframammary fold incision allows for easier placement of the implant, simpler pocket...
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Risk of Infection based on Incision Point?
I don't think that there is any difference. Infection is rare by any incision and is not more common based on the incision point.
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Periareolar incision
There is no study or series that I know of that definitively answers your question, which is a very good one. There has been at least one well designed animal study that shows low level bacterial infection on implants increases the chance of capsular contracture. We also know that bacteria often live in breast ducts. It's easy to put these two things together but it ain't necessarily so. I think it's super important to absolutely minimize contact...
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Risk of capsular contracture more related to implant location than incision site
Bacterial infection of a breast implant can occur with any incision site whenever there is a break in sterile technique. Although there is thought to be a correlation between bacterial colonization of a breast implant (not overt infection) and development of capsular contracture, there are no studies demonstrating this effect. However, there are studies that show higher rates of capsular contracture for implants placed in the subglandular position (above the muscle) than for implants in...
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Breast implant incisions
I use the peri-areolar incision almost exclusively. In my experience the incidence of capsular contracture or infection is very low and no different than any other incision. The inframammary incision is good but it will reult in a bad scar in about 10-15% of patients and then it will be noticeable if the bra or the swimming suit rides up. I literally most times cannot find the peri-areolar scar after several years on my patients.
If your plastic surgeon is not using that incision,...
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Periareolar vs inframammary incision for breast augmentation
I do let the patient decide what incision to use, but I prefer the periareolar. There is no increased risk of infection nor loss of sensation. If the patient need a lift in the future, then the incision can be extended all of the way around to accomplish this. I have seen some inframammary scars that have ugly widening and prolonged erythema.
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Periareolar vs inframammary fold incision for breast augmentation
From a practical standpoint there is no increased risk of capsular contracture when performing a periareolar incision when compared to an inframammary fold incision. Fortunately, with the use of cohesive gel silicone implants, or ones that are saline, the incidence of capsular contracture has dropped to such a low percentage that surgeons who have been operating for a decade (or two!) are now much less concerned about this complication than we were years ago.
Infections with...
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Periareolar Incision Risks
I typically allow my patients to choose their incision of choice. Although it seems theoretically possible to have a higher incidence of infection and sensation change with the peri-areolar incision, it has never been shown to be true in the literature. Therefore, I let the patient choose, although I point out that the peri-areolar incision may be easier to hide in patients with small breasts and wide areola or a lack of an inframammary fold.
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.
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