What are the risks of a periaerolar incision?

Bacterial infection of a breast implant can occur with any incision site whenever there is a break in sterile technique. Although there is thought to be a correlation between bacterial colonization of a breast implant (not overt infection) and development of capsular contracture, there are no studies demonstrating this effect. However, there are studies that show higher rates of capsular contracture for implants placed in the subglandular position (above the muscle) than for implants in the submuscular position (over the muscle).

There are 3 primary  incision options for breast  augmentation. All are acceptable and depend on the patient's choice and the surgeon's experience and expertise-

1. The most common approach is in the Inframammary Fold - simple, easy access , heals well , and gives the best opportunity for correction of any subtle  breast asymmetries. It is the most common incision I use for both saline and silicone implants.  In my experience, it has a very small nipple sensory loss incidence.

2. the Periarealar approach - must be made precisely in the areolar -breast skin interface to prevent the scar from being visible .  There is no good data to support that it causes more infection or implant contracture. Therefore, it really comes down to surgeon and patient preference.  I use it in patients with almost no breast tissue or no apparent inframammary fold . It is not my preferred approach

3.  The Transaxillary approach- the armpit incision is also a good approach and was popular in the 90's and is use more in certain regions of the USA than others due to surgeon and patient preference.   Again, it has no distinct disadvantages except perhaps it is more difficult to correct primary breast asymmetries using this approach