Considering a breast augmentation - which incision placement would work best for me? (photos)

Question

Hello, I am 30 years old,breastfed 2 kids. My height is 168 and weight 52. I had C section with my second baby and I got keloid scar. I want to do breast augmentation for a long time, however, I have a problem that my Areola is located in the lower pole of the breast, which means that I have only 2-3 cm between lower areola and breast fold. I also have a little breast tissue. Can you please recommend whether I should do incision under the breast fold, making new fold lower or around areola

Christopher Pannucci, MD, MS · Answer

Hi arua,
An incision underneath the breast would be favorable for 2 reasons. First of all, if you are prone to keloid scarring, an under the breast incision would be better hidden than a incision around the border of the areola. Second, incisions under the breast are known to have a lower risk for infection around the implant, when compared to incisions around the areola.
Hope this helps.
Best,Christopher Pannucci MDBoard Certified Plastic SurgeonPlastic Surgery NorthwestSpokane, Washington

Chul Hwan Seul, MD, PhD · Answer

For those with a history of childbirth, the skin of the lower pole is loose, so even those with a short nipple to inframammary fold (IMF) distance have a good IMF scar quality. However, if the keloid tendency is very strong, an auxiliary scar may also be bad. Therefore, it is better to decide on the preferred location under the assumption that there is a high possibility of scarring no matter where the incision is made. The periareolar incision has a higher capsular contracture rate and a higher possibility of sensory change than other methods, so it is not used well these days.

Elisa A. Burgess, MD · Answer

For my patients, I typically make an incision in the inframammary fold which is the fold under the breast. That way when the implant settles that it will hide the scar when you are upright. I really have not had a patient complain about this scar. However any scar can be visible but hopefully the color will fade with time. Look at our photo gallery link below. The majority of these has the incision in the inframammary fold.

Albert Ko, MD · Answer

Hi there,Thanks for your question! I would reccomened an inframmamory incision for your breast augmentation. You should consult with a board certified plastic surgeon in-person to discuss your goals with surgery.

Derek Fletcher, MD · Answer

I would recommend a breast fold incision. This gives me the ability to adjust the position of the breast fold to fit your new breast size. It is also the safest approach with respect complications like capsular contracture. Having a keloid C-section scar is an important observation. But it does not necessarily mean you will form a keloid scar from a breast incision.

Brian K. Reedy, MD · Answer

Thanks for your question! I think an inframammary incision or periareolar incision would both be options for you. The IMF is the safest approach, but your areola is large enough that it could be viable option. I would suggest an in-person consultation for a full evaluation. Good luck!

Daniel Barrett, MD · Answer

Dear arua,
I almost always place implants submuscular. It lowers the rate of capsular contracture significantly. In addition, it looks much more natural because the muscle provides covering over the implant so its not as round on the top. I've also noticed the implants drop less over time when they are protected under the muscle.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Edwin Kwon, MD, FACS · Answer

The three main incisions for breast augmentation are IMF fold, peri-areolar, as well as trans-axillary.

It appears that your left breast fold is higher compared to your right and will need to be lowered for better symmetry.  I typically advise patients away from peri-areolar incisions as they have the highest rate of capsular contracture.  You may consider a trans-axillary approach as these scars heal very well and are difficult to see.

Hakan Demir, MD · Answer

1-your breast's folds are different localization .that means they should be to equalized in the operation made by folds incision. 2- areolar incision will be caused enlargement areolar size at only breast augmentation surgery3- areolar incisions may be resulted nipple sensation. dr.hakan.demir Antalya Turkey

Ersin Gonullu, MD · Answer

you look you have Brest atrophy in both side which is more significant on the left. nipple-imf distance is short in both side and needed to be lowered and make them on the same level. because of inadequate breast tissue dual plane implant pocket with a tear drop implant will be better and give you more natural result. the incision can be placed on neo imf. you have hypertrophic scar on cx incision and steroid injection is so helpful for this kind of scars. fyi. regards

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