Normally Secrete White Solid Substance from my Nipples During Menstrual, Can I Still Go Through AREOLAR Breast Augmentation?

I normally secrete tiny white solid substances from my nipples during menstrual or when there's a lot of pressure on my breasts from wearing a tight push up bra. I want areolar approach bc I am Asian, scar easily, thin skin, weight 105-110 pounds, cup size A/B and want to go full C w/ silicone implants. I am afraid of inframammary approach b/c of extrusion, although there is a less chance of infection. I think both methods are risky for me. What should I do? Has anyone had a patient like me?

Doctor Answers 13

Periareolar incision for breast augmentation in Asian patients

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Our jobs as surgeons can be described as "risk management," as opposed to risk elimination.  By that I mean that we often have to take stock of all risks involved in each particular case and make the best decision taking all things into consideration, knowing that we will always have some risks but we try to pick the lowest risk plan for our goals.  In your case, your Asian heritage may predispose you to more visible scars in the inframammary location, however, a periareolar incision may predispose you to a higher risk of capsule contracture, especially if you tend to secrete colostrum or have keratin debris in your milk ducts, which can cause contamination of the implants.  Nipple shields can certainly be used, but I still think the risk is greater.  Dehiscence, or opening, of infamammary incisions can happen leading to extrusion of implants, but in my experience this is extremely rare, especially if the wound is properly closed with an adequate layered closure.  I would not be opposed to placing implants in someone like you using periareolar incisions, but you would have to know that your chances of capsule contracture, nipple insensitivity, and effects on breastfeeding may be greater.  On the other hand, if implant extrusion is your biggest fear about inframammary incisions, I would tell you that this is very, very unlikely, and I would suggest that approach because in general it will have the least risk for you.  Good luck.

San Diego Plastic Surgeon

Can I Still Go Through AREOLAR Breast Augmentation?

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My general preference is for incision in the breast fold, all the moreso with your history of nipple secretion. I know of no increased risk of extrusion through the fold incision. 

The pros and cons of the three incisions that can be used for silicone should be carefully reviewed with your surgeon. All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Normally Secrete White Solid Substance from my Nipples During Menstrual, Can I Still Go Through AREOLAR Breast Augmentation?

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    No one approach will be without risk.  I think that any of the four approaches have positives and negatives, and you should find a surgeon who offers all four so that you are not boxed into one.  Admittedly, you cannot place silicone implants through the belly button, but this route would have the lowest risk of infection and extrusion without concerns for the galactorrhea.  Find a plastic surgeon with ELITE credentials who performs hundreds of breast augmentations each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

Normally Secrete White Solid Substance from my Nipples During Menstrual, Can I Still Go Through AREOLAR Breast Augmentation?

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Dear Candyplease,

Thank you for your question.  While doing an areolar incision is ok for you from the point of infection, I would consider doing an inframamary incision or axillary incision on you.  If you scar poor, you probably do not want a bad scar around the areola.  This can look like a smiley face with a bad scar.  This is much better hidden in the crease or the axilla.  I do all three incisions, but usually recommend the areola incision in patients who have already proven they do not have hypertrophic scars from a previous incision.  You should not have any additional risk of extrusion through a breast crease scar if you choose an appropriately sized implant.

Best Wishes,

Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
4.9 out of 5 stars 42 reviews

Options of incisions for breast augmentation

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It is not unusual for women to have some secretions from their nipples during their menstrual cycle, and this should not preclude you from having a breast augmentation with a periareolar incision.  You may also be a candidate for a breast augmentation via an axillary incision in the armpit.  This incision is very well hidden and would avoid the ducts around the nipple.  Best wishes.

Vincent D. Lepore, MD
San Jose Plastic Surgeon
4.7 out of 5 stars 63 reviews

Breast augmentation approach

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Different board certified PS have different preferences on their approach for breast augmentation.  The drainage you describe during your menstrual cycles should not prevent you from having breast augmentation.  I'm not sure why you think an inframammary fold approach will increase your risk of extrusion - there is no evidence to support this whatsoever.     I decide on the approach based on the patient's anatomy.  The question is: where can I hide your scar the best.    There is however some evidence to suggest that the periareolar approach may increase your risk for scar tissue formation on your breast (capsular contracture) over time.   Please visit with a board certified PS to learn more about your options. Best wishes. Dr. Basu Houston, TX

Which approach for augmentation?

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The ductal secretions from the breast should not preclude you from having breast augmentation surgery.

In terms of the approach, they are both well practiced procedures and standards practices.  These should be discussed with your surgeon and I think that either approach will be adequate for you.


Stephen Salerno


Stephen Salerno, MBBS, FRACS
Melbourne Plastic Surgeon

Breast augmentation

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I would recommend the inframammary approach.  I have never seen extrusion of an implant when done this way, but I have also never seen an infection from a periareoalar incision either.  Either option is okay and your choice really should come down to your personal preference.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 29 reviews

Periareolar Approach To Breast Augmentation

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The incision around the areola is a good choice for women with large, dark colored areolae.  If the size is small, there will be a lot of stretching on the tissue while inserting the implant and therefore worse scarring.  If there is a milky discharge from the nipple either during menstruation or after nursing, there may be a slightly higher risk of a subclinical infection of the implant leading to future capsular contracture.

The approach through the breast fold (inframammary) allows for a slightly longer scar to accommodate a larger implant and it can be very inconspicuous if placed properly.  The risk of extrusion is quite rare and no greater for one approach over the other.

Martin O`Toole, MD, FACS
Los Angeles Plastic Surgeon

Reconsider the desire forperiareolar incision.

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The periareolar incision might increase the risk for capsular contraction because of bacterial contamination. Consider an alternative incision.

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.