Am I a Candidate For Nipple Incision With Very Small Nipples?

Commonly areola incision can be used for placement of breast implants. However, when the areola is too small that can create difficulty in placing the silicone implants.

Saline implants are easier to place as they can be rolled in and then filled with saline solution.

Hope this helps.

Ali Sajjadian, MD

Just because it is possible doesn't mean it is a good idea.  You have given several reasons why it is not optimal.

-Large implant size

-Silicone implant

-Small nipples

-Lightly colored nipples

If you try to force a large silicone implant through a small incision, the silicone implant shell could be damaged which would weaken and shorten the life expectancy of your implants.

The inframammary and transaxillary incisions are good alternatives.

I hope this helps.

There are widely varied opinions about how large an areola must be to allow this approach. Unless your areola is VERY small (<3cm diameter) or the coloration is very close to the surrounding tissue, you may be a candidate. It is ultimately up to the physician's experience and comfort level. I encourage you to ask a prospective surgeon, what percentage of their breast augmentations are done through your preferred approach.

It is possible to place implants up to 550 cc through an areolar size of at least 3 cm.  This is best performed using the specific device called a Keller funnel.  You should your board certified plastic surgeon regarding use of the same.  I believe this device decreases the chances of damaging the implant while being introduced through a small incision.  Good luck.

Because a silicone gel breast implant comes pre-filled, it is very difficult to introduce a large implant through a small incision under the areola.  Typically, this approach is not offered to patients whose areolar diameter is less than 3cm, or an inch and a half, across.  This is because the incision ends up being so short that the operation cannot be effectively performed through it, and the large implant may be damaged in trying to introduce it through a small scar.

 

Also, if your areola is lightly pigmented, the areolar scar may end up looking quite visible.  This is in contrast to the under-the-breast (inframammary) scar, which is camouflaged well by the breast crease.

 

All the best,

Dr. Skourtis

If the areola are not a reasonable size, it becomes very difficult to try to place a large implant through that pocket. It is easier with saline implants because they are rolled into a small cigarette like shape and then expanded inside.

Its not possible with such small  areola to insert a big implant plus there is no advantage to use this access since the color is light,so the scar will be obvious 

In my experience, if your areola is 3cm in diameter, I can get an implant in. I have put in implants up to 600ccs. Use your math - the size of the incision needs to be at least 4cm -- so take the circumference  multiply by Pi and divide by half. Thus the diameter needs to be at least 3.0cm.

It is unlikely 420 cc silicone gel implants could be placed through a periareolar incision in someone with with very small areola. Loose rule of thumb is you need about 1 cm of incision length for every 100cc of silicone implant. Thus a 420 cc implant would need over a 4 cm incision to decrease the risk of damaging the implant while trying to place it through too small of an incision.

Nipple incision and areola incision are quite different so I will assume you mean areola as that is a common approach. If you have seen a good surgeon and he can do the surgery and you have seen two who can't, why not go to the one who can do it? As with Dr. Rosenblatt, i have no trouble getting a 420cc silicone implant through a 4 cm incision. But even if midsurgery your doctor discovers it isn't working, a 1/4" extension of the scar away from the areola will be all that is necessary and it will not be visible without very close scrutiny. That's the approach I use for larger silicone implants so I know how well it works. However, the more color difference there is between the areola and the breast skin, the better the scar will hide. If you are at all worried then go ahead with the incision near the fold. Without photos of your particular anatomy is is impossible to give you more specific info.