Incision around nipple inside of the areola?

Hello! I was reading about a week ago about some South Korean plastic surgeons making areaolar incisions but instead of going on the edge of the areola they go on the inside around the nipple. I haven't heard of any American doctors doing this; is there a reason why? It seems like the main benefit would be to have a more natural areola edge with the flexibility of making it smaller. Right?

Doctor Answers 16

Incision inside the areola not along the border?

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 Women with very dark areolar skin heal very nicely with this intra-areolar incision. I usually use this approach only for African American or Asian women. The scar is barely noticeable, whereas on Caucasian women, this approach leaves a white line in the lightly pigmented areolar skin. In fact, this scar heals better on women of color than the inframammary incision does.

Jacksonville Plastic Surgeon
4.9 out of 5 stars 33 reviews

Areolar incision

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i feel that the areolar incision is not the most ideal. if the cut is not ideal or your body does not heal appropriately then it is much more visible. 

Incision around nipple inside of the areola?

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Incisions through the areolar have not been shown to be a good aesthetic choice.  A white line will usually appear where the incision was made whereas the border incision usully is hidden with time.

Thomas Guillot, MD
Baton Rouge Plastic Surgeon

Incision around nipple inside of the areola.

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An incision inside on the areolar skin proper results in a white visible line in the areola and most often will not conceal the scar as well. The edge might be better, though the scar might be a detraction. I feel some have learned this through experience.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Incision around the NIPPLE for breast augmentation

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There are a few reasons why I feel an incision around the nipple to perform a breast augmentation is a BAD idea:
1. The area can not be cleaned as well due to the lactic ducts and therefore would probably increase your risk of infection. 
2. Increased risk of losing nipple sensation. 
3.  Technically impossible to get a silicone implant in due to the short incision. 
4.  Risk of nipple deformity during healing that would be very visible. 

I perform most of my breast augmentations through a sub-mammary (below the breast) incision. I feel this approach gives the best surgical visibility and therefore the best surgical result (pocket, placement, bleeding). The scars in this location heal very well and are small. The typical length of the scars are 2-2.5cm for saline implants and 4-5cm for silicone implants. 

I also perform periareolar (around the areola) and trans-axillary (armpit) augmentations. These approaches have limitations to the size of silicone implant that can be placed and therefore are not an option for some patients depending on the size and style of implant they want. 

Good luck and do NOT get a Peri-nipple incision. Please. 

Julian Gordon, MD
Alpharetta Plastic Surgeon

Breast Augmentation Incision

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Saline implants are able to be placed through a smaller incision since they are inflated once inside the breast pocket. Silicone implants are pre-filled and require a larger incision. It would be difficult to place implants through the described incision.

Incision inside the areola for breast augmentation.

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What you are describing is called  a transareolar  incision. This incision runs through the center of the areola skirting the nipple. I don't like it because it cuts through the nipple ducts  releasing bacteria in them into the wound causing patiients  more infection  and capsular /scar problems.

Sumanth Pagadala, MD
Columbus Plastic Surgeon
4.6 out of 5 stars 48 reviews

Incision inside areola for breast augmentation

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I don't use areolar incisions for the simple reason that if they heal poorly they are impossible to hide.  Making the incision around the nipple would risk killing the nipple and/or deforming it.  It would also make future breast feeding impossible.  

For good reason

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There are several good resaons not to do thawt incision. My first concern would be the amount of scar introduced into the duct system of the breast. This could severly harm ones ability to breast feed. Second, this puts nipple sensation at greater risk. Finally, good studies show that capsular contracture rates are highr in any peri-areolar incision and should be done with proper reverence.

Stephan Finical, MD
Charlotte Plastic Surgeon

Stick with Proven Techniques

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Location of the incision, location of the implant, type of implant, and size are all critical questions for women who choose breast augmentation. There are different considerations for various parts of the operation, and plastic surgeons are trained differently and have varying levels of experience.

The key is to work with a Board Certified plastic surgeon with expertise and experience in breast augmentation. He or she should be able to clearly explain their approach and why they do things a certain way.

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.