How likely would the nipple invert with a periareolar incision for breast augmentation?

Hi passionfruity,
Thank you for your question. The good news is that breast augmentation through a periareolar incision should not lead to further inversion of your nipples. In fact, your nipple inversion could even be corrected during your breast augmentation procedure if you so choose. The main risks with periareolar incisions compared to an incision in the breast fold are a theoretically increased risk of capsular contracture due to contamination of the implant by the milk ducts, as well as the potential for depressed scar if the closure is not performed correctly. Additionally, depending on your areola size, you may or may not be a candidate for this approach, but this would need to be determined by your surgeon at your initial consultation. As far as scarring, this will depend on individual factors and likely related to how you have scarred in the past. I hope this helps!

I highly recommend avoiding any periareolar incision at all cost for multiple reasons including poor scarring, higher risk of infection, higher risk of capsular contracture, nipple pain, scar widening, scar tethering, potential disruption of milk ducts, and more.

Although scarring can tether the nipple and cause inversion, the risks are very low. As an Asian, you will likely have more pigmentation and therefore a more persistent darker scar then someone of a less pigmented ethnicity.

Performing a breast augmentation through a periareolar should have no affect on your inverted nipples. However. there is a procedure that can be done at the same time that can correct your nipple inversion. I would consult with your local plastic surgeon and discuss your options.

Hi! Not likely at all. The periareolar incision will not affect your nipple. The nipple will actually stay the same. Inverted Naples can be corrected during a breast augmentation, especially if it is periareolar. This incision is a great option because it is hidden between the different skin tones on the edge of the areolas.

Best of luck,

Dr. Miguel Mota

Dear passionfruity,
I tend to prefer the periareolar incision because its the most well hidden. There is a natural border between the areola and the rest of the breast skin the hides the incision extremely well. You have to be completely naked to see it vs other incisions like transaxillary and inframammary are visible in clothing such as sleeveless shirts and bikini tops when extending your arms up. I've also noticed increased rates of bottoming out with inframmary incisions that is not reported. Transaxillary implants are always wide in appearance because the surgeon is not able to dissect medially enough to provide better cleavage. Ultimately, I can perform any of the incisions but I recommend the periareolar. There is no difference in sensation because the nerves that control nipple sensation come in laterally from the back and injury to them occurs when surgeons dissect to far laterally which is why transaxillary incisions have the highest nipple sensation disruption. There is no difference in breast feeding ability. One study did show a slight increase in capsular contracture with use of periareolar but that study was small and did not incorporate modern techniques such as below muscle placement, keller funnel usage and triple antibiotic irrigation.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Your nipples shouldn't invert more than they already are with a periareolar incision. That being said, whether that is the best incision for you depends on a number of things beyond just your ethnicity, especially regarding your breast shape and anatomy. In person consultation and discussion would be the best way to evaluate and help make that decision.

I appreciate your concerns however, you do have options. First off. Correction of the inverted nipples can readily be performed at the same time as your breast augmentation. A very small incision just below the nipple is required for correction. However the incision for your breast augmentation would suit you better when placed in the inframammary fold, especially with your concerns about scarring. The scar is camouflaged by placement within the fold and then covered by the breasts after they are enlarged by the augmentation. Come see me or another board-certified plastic surgeon in our area to explore the best options for you. Good luck.

It has been established for many years that not all incisions are equal when it comes to breast augmentation. The periareolar incision has the highest risk for capsular contracture and other scar related deformities. Inframammary incisions carry the lowest risk and are not necessarily aesthetically inferior. You can correct nipple inversion and breast augmentation simultaneously, but you should consider the inframammary route.

Breast augmentation will not affect position and retraction of nipples whether periareolar or lower pole incision is used. However, if you want to have both augmentation and inverted nipples repair, IMF incision would be better approach. Periareolar incision also decreases sensation of nipple to a certain degree; Scars around areola are more noticeable, in my opinion. That is not my preferential approach to breast augmentation but it is very successfully used by many plastic surgeons. This is best to be discussed with your surgeon ahead of surgery. Hope this helps.