Breast Tissue and the Periareolar Incision?

I am scheduled for a BA on October 24th, 2012. I am having 300cc cohesive gel implants inserted through a periareolar incision and they will be placed under the muscle. My question is this, since the PS has to cut through the breast tissue will this leave my natural tissue lumpy or cause dimpling or any kind unsightly or physical ramifications? Or does the breast tissue repair itself back to its pre-surgery state?

Doctor Answers 15

Periareola incision and implants

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Using a periareola incision is a very popular approach for implants placement. It is unlikely to have any issues that you described.

New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Periareolar incision and breast augmentation

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Periareeolar incision can be used for both sub-pectoral and sub-glandular placement of implants. The advantage is that the incision is less visible due to the color difference between skin and aureola. However in order to place the implants, breast tissue has to be dissected and some scarring will occur within the breast tissue. A precise layer closure will prevent visibility of these scars, but the may be palpable if not closed properly, and some scarring may be seen on mammograms in the future. If there is a breast fold, infra-mammary incision avoids the issue scarring in the breast since dissection avoids any breast tissue, but the scar may be more visible but the breast fold if present will hide this short scar.

Shahriar Mabourakh, MD, FACS
Sacramento Plastic Surgeon
4.9 out of 5 stars 227 reviews

Will a periareolar incision and under the muscle approach for breast augmentation result in lumpiness?

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The periareolar incision and placing the implants under the muscle is a very common approacj which usually leads to very satisfactory results. It is very rare to get any kind of postoperative lumpiness as a result of cutting through the breast tissue to have access to the behind-the-muscle pocket. Good luck!

Periareolar incision

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As long as you heal properly, the location of the incision should not affect your breast tissue or nipple sensation or the ability to breast feed.

Leonard T. Yu, MD
Maui Plastic Surgeon

Periareolar breast incison should not end lumpy

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The periareolar incision gives access to  the lower edge of the breast, and generally a subglandular pocket is developed up the the chest muscle and then continued under the muscle above. If the breast is closed by 'layers' the incision or breast should not be lumpy or affect the nipple either.

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

Breast Tissue and the Periareolar Incision

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If any of the commonly used incisions were demonstrably superior to the alternatives, we would all use the same incision. And we don't.  My general preference is for an incision under the fold, which does minimized the tampering with breast tissue.

But surgeons get excellent results with any of the insertion sites. Best discussion of the issues involved would be with your surgeon, who can review the pros and cons base upon your individual anatomy and goals.

Best wishes. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon


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Nothing is guaranteed, but most of our patients when they do the incision through their nipple it come out really nicely. The skin around the areola is very thin and the scar is very forgiving. You have scar therapy you can use to help the scar be is minimal as possible.



Stuart B. Kincaid, MD, FACS (in memoriam)
Beverly Hills Plastic Surgeon

Breast Augmentation Incision

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There are several ways to place the incision so that it is well hidden in natural skin folds or breast transitions.
  • 1.Periareolar
    • a.Hidden at the natural transition from the areola and the breast skin. The incision can be hidden in this natural color transition.
    • b.It would be extremely rare to have any of the symptoms that you describe in your question. Patient in general do extremely well with the periareolar breast augmentation.
  • 2.Inframmary Fold
    • a.The incision is hidden in the fold below the breast.
  • 3.Axilla
    • a.The incision for the implant can be hidden in one of the natural axilla folds. I do these with the aid of scope which allows precise placement of the implant.
    • b.Also the use of the Keller funnel has allowed the placement of larger silicone implants through the axilla.
No one incision is best for every patient and the majority of patients can have the implant placed through any of the three incisions listed above. When do correctly all three of the incisions are well hidden.

It is important to see your board certified plastic surgeon to help guide you to an implant that will give you an aesthetically pleasing breast.

Periareolar incision

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Lumpiness, dimpling or other "unsightly ramifications" are not related specifically to the periareolar approach when the surgery is performed correctly.  My patients have obtained beautiful, natural looking results with this  incision.

Periareolar Breast Augmentation

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If you do not have a small areola then a periareolar approach is reasonable and the complications you listed usually do not occur. However, you should be aware that there is a higher risk of capsular contracture and not being able to breast feed with this approach. A inframammary approach would probably be the safest with least risk of complications.

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.