Can I get periareolar/keyhole? I’m a cup B

Hi x076nk,



I understand that you are concerned when it comes to the different incisions used in breast augmentation surgery. There are different techniques used and each technique has its own advantages and disadvantages.

Personally, I tend to prefer the periareolar incision because it is 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 versus other incisions. Transaxillary and inframammary incisions 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.

Also, 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.
You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals. 
Daniel Barrett, MD, MHA, MS

Certified, American Board of Plastic Surgery

Member, American Society of Plastic Surgery

Member, American Society of Aesthetic Plastic Surgery

hello thank you for your question and provided information as well..Based on your photo I see that you are a good candidate for a breast lift with implant.in your case it would be ideal to use small implants to obtain a better projection.  To determine the technique, it is ideal to have a consultation with your certified plastic surgeon to see you and determine which would be the correct one for your case.

I would recommend a crescent lift with your augmentation to elevate the nipple position at the time of your implant placement.  Otherwise, if this is not done, the nipples will look like the are falling off the implant.  A reasonably size implant will lift your breast up too.  

I do not feel you need any lift at all. I think a dual plane augmentation would get you a great result without the cost or scar of a lift. Good luck.

Hello and thank you for your question. You are a great candidate
for a breast augmentation using a dual plane technique without need for a formal lift.  The size, profile, and shape of the
implant is based on your desired breast size/shape, your chest wall
measurements, and soft tissue quality.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.  This entire surgery
can be performed with a small incision technique.  Make sure you
specifically look at before and after pictures of real patients who have
had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a
surgeon you are comfortable with. I recommend that you seek consultation with a
qualified board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D. FACS
Harvard-trained plastic surgeon

Thank you for your question. The size or diameter of your areola will determine if you have enough room for a periareolar incision.However I would urge you to consider an inframammary crease incision. Using the periareolar incision cause a higher chance of capsular contracture following breast augmentation than does an inframammary crease incision using the dual plane submuscular approach.

Hello, You really need an in person evaluation to determine your suitability for a given procedure.  Best,

Jon Ver Halen, MD FACS

Harvard educated plastic surgeon

Texas “Top Doc”

RealSelf100

America’s Top Plastic Surgeons, Consumer’s Research Council