Is areola incision a non existent thing now ? Looking for a revision but do not want an incision in the breast fold. (Photos)

It is true there is a tendency or fashionable way of conducting primary and secondary breast augmentations among surgeons, which makes them favor the submammary crease incision; why so? it is a time and hassle saver for them, to the price of more visible scarring, suboptimal results, more tendency to haematoma (haemostasis is non completely accessible), etc.

Do request, in a nonnegotiable manner, to be operated via hemi-periareolar incision, the scar is going to be indetectable, mostly considering the relatively large size of your areolas.

Surgery through the infra-areolar incision/scar is highly NOT recommended. This is due to the fact that the entire breast tissue/parenchyma has bacteria. The implant will be inherently contaminated when being inserted as it will rub against all of the breast tissue ducts/ductules on the way to the pocket. This will increase your risk for capsular contracture and infection.

Dear Nice18501,

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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thank you for your question. I have been in practice for over 30 years and revisionary breast surgery is a large portion of my practice. I totally agree with you that the periareolar incision heals better. In my 30 years in practice, I have never embraced the inframammary crease incision. I believe that this incision can heal nicely, but oftentimes is visible and can ride up on the breast itself. I have gone through the periareolar incision many times on the same patient without any indentation at all because I excised all the residual scar tissue each time I perform a periareolar incision. You should be able to have an excellent result. Best wishes to you.

Dear New Yorker,
I agree with you. Sub areola incision is the best approach for breasts augmentation surgery for many reasons. I have been using that technique for 38 years on over 3000 patients and used exclusively saline implants. From observing your picture it appears that you have quite large areola. You can benefit from areola reduction using the mini lift (donut) technique if it is a concern for you.
You are welcomed to contact my office if you can't find a surgeon in your area who specializes in sub areola incision for breasts augmentation surgery.
Always consult with experienced board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, check the before and after photo of breasts augmentation revision in the photo gallery to make sure that they are numerous, consistent and attractive with nice scar, nice cleavage, nice projection, full upper pole and natural looking.
Best of luck,
Dr Widder
widderplasticsurgery.com
703-506-0300

Yes , absolutely. It is true that most surgeons have limited experience with peri areolar incisions which are used less commonly today but they are still very suitable for saline implants and smaller silicone gel implants depending on the size of the areola. There is no reason why you couldn’t have your implants replaced through an areolar incisions which which I still use routinely for those patients who prefer it. It does add somewhat to the length of the surgery and is technically more demanding.

There is no ideal incision. If there was then all operations would be done thru that incision. Most if not all plastic surgeons can use the PA incision. There are no experts in this incision. I have seen complications and visible scars in all breast incisions. Find a surgeon who you are comfortable with and good luck.

Based on your one post a photo, many doctors, especially board certified Plastic surgeon would still use the nipple complex incision to do an implant exchange and attempt to get cleavage. Correction exchanging into silicone implants is done with use of a specialized insertion device called the KELLER funnel. Best of virtual consult with for better understanding fee is $10,000. Again, best of virtual consult with.

The Peri areolar incision is for many patients the ideal approach for implant augmentation, especially when using saline implants.
For fair skin people, it is the preferred approach in my opinion.
It has so many advantages over other approaches.
It can be done for silicone implants if the Ariola is on the large size.
I found some of the most experienced breast surgeons preferred this approach.
The IMF approach is technically easier, but has some disadvantages.
I guarantee you there are still plastic surgeons who have experience with the Peri areolar incision. Maybe call around and ask each office before making an appointment.
Finding the right plastic surgeon is really important.
Ask providers to open up their portfolios and show as many before and after pictures of previous patients who have similar body characteristics to your own to help that plastic surgeons.
Highly experienced surgeons should have no limitation in regards to the number of before and after pictures they’re willing to show you.
Good luck,
Mats Hagstrom MD