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

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.

Los Angeles Plastic Surgeon
5.0 out of 5 stars 254 reviews

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. 

Wm. Todd Stoeckel, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 87 reviews

Will Areola Incision Damage Milk Ducts?

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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
4.9 out of 5 stars 109 reviews

Areolar versus inframammary incision

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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.

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.

Will Areola Incision Damage Milk Ducts?

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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
4.6 out of 5 stars 15 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.

Choice of incision

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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
4.8 out of 5 stars 21 reviews

Best Incision for Breast Augmentation?

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Thank you for the question.

 You will find that, like many things in plastic surgery, every doctor will have “strong preferences” about a certain issue. This preference does not necessarily mean that one way of doing things is better than the other.

Each plastic surgeon may have his/her opinion that is based on their specific/unique education, experience, and personal preferences. Their opinions may also be shaped by unfavorable results they have encountered in their practices.

Although these different opinions can be confusing and a source of anxiety for patients, it is good for patients to understand the different options available. Ultimately, it will be up to each patient to do their due diligence and select their plastic surgeon. Part of this selection process will involve the patients becoming comfortable with the plastic surgeon's experience level and abilities to achieve their goals as safely and complication free as possible.

 In my practice, (like your plastic surgeon's)  I have come to prefer the infra areolar approach  for most patients undergoing breast augmentation surgery.  I have found that (again in my opinion) the advantages outweigh the disadvantages.

 Although no plastic surgeon can guarantee that you will be able to breast-feed ( whether or not you have breast surgery), I have found that my patients have successfully breast-fed after breast augmentation surgery.

 Best wishes.

Areolar incision is avoided by most surgeons today

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The areolar incision was preferred over others because of the inconspicuous scar and I used it for many years. It does injure some of the breast and ductal tissue. The main reason I switched to the inframammary crease incision is the issue of capsular contracture. There is bacteria in the milk ducts and patients with periareolar incisions have many times the incidence of capsular contracture than patients with IMC incisions, even with the use of a Keller funnel insertion sleeve.

John Squires, MD
Denver Plastic Surgeon
4.9 out of 5 stars 82 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.