Risk of capsular contracture with periareolar incision and subglandular placement? (Photo)

Yes, both the periareolar incision and subglandular placement increase the risk of capsular contracture (assuming you're using a smooth implant). Inframammary fold incisions are generally safer (lower risk of capsular contracture), allow for more precise implant placment, and if they are planned properly the scar hides beautifully in the fold underneath your breast. If you want to have the implant above the muscle (if you work out a lot, or are worried about animation deformity), subfascial placement tends to have lower capsular contracture and hold up better over time than subglandular based on the studies we have.

Yes, it is well known that there is significantly higher risk of capsular contracture with all incisions that are not inframammary (in the breast fold). I would recommend seeing a board certified or board eligible plastic surgeon with aesthetic surgery training/experience who can perform a full exam and provide safe recommendations.

Hello,
Thank you for the question.
The breast implants are typically placed under the muscle using a small incision at the breast fold in order to provide more soft tissue coverage for the implant and to minimize the risk of capsular contracture which is higher when implants are placed via nipple-areolar incision in the subglandular plane.
I would seek an in-person evaluation by the Board-Certified Plastic Surgeon, in order to discuss your goals and concerns for the best cosmetic results.
I hope this helps.Best regards, Dr. Karanetz
Dr. Irena KaranetzBreast Fellowship-TrainedBoard Certified Plastic Surgeon

Hi Optimistic462204
Publisehd medical peer reivewed literature does state there is a higher capsular contracture risk with not only periareolar incsions but also sublglandular implant placement. There is also some literature that would say the differences in approaches doesn't matter. Each surgeon has their own preferences in incision and implant placement so make sure you are aware of what the plan for your body is prior to surgery. Best wishes,
Dr. Andre P. MarshallDouble Board Certified Plastic SurgeonBeverly Hills, CA 90210

Thanks for your question! Yes, the risk is increased with that incision and with a subglandular placement. I would strongly encourage an in-person consultation with a board-certified plastic surgeon to evaluate the best options for you. Good luck!

Thank you for your question. A large portion of my practice is dedicated to breast surgery and revision breast surgery. I believe that you can achieve excellent results with any of the 3 major incisions: Periareolar, inframammary crease, and/or axillary approaches. I would caution you against having a subglandular placement of implants. I have found that the rate of complications including wrinkling, capsular contracture, and sliding down your chest wall with time occur too often with subglandular placement of implants. Best wishes to you.

Dear Optimistic462204,
capsular contracture happens. In fact, every implant has a capsule form around it, its just a certain percentage develop thick capsules. There is a lot we don't know about it actually. Some think that bacteria that gets on the implant during insertion can increase the risk. Thats why we use a Keller Funnel in our practice to reduce that possibility. Our capsular contracture rate is less than 2% because we use a keller funnel as well as meticulous operating room techniques.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

I recommend inframammary incision and sub muscular placement for lower risk of contracture. I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants, and they choose what looks right for them. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

There are numerous published reports which confirm that both peri-areolar approach and subgladular placement, increase the risk of breast implant contracture. In person evaluation and discussion about risks, with a board certified plastic surgeon, is recommended. Good luck.

There is an increased rate of capsular contracture with peri-areolar incisions and subglandular placement compared to the inframammary incision and submuscular implant placement. Inframammary incisions are generally well hidden within the breast fold, and a very natural look and feel can be achieved with implants placed under the muscle.