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.
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.
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.
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.
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.
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.
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.
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.
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.
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.