Thank you for the question. There are several good approaches to breast augmentation surgery; different surgeons will have their own preferences. In my practice, I prefer the inframammary or infrareolar approach for most patients. For patients with very little breast tissue and/or underdeveloped inframammary fold areas, I tend to recommend the us of an infra areolar approach. Despite what you may hear, I think most patients can have the infraareolar incision used regardless of the size of breast implants or size of areola. The Keller funnel has made the insertion of all sizes of breast implants much easier. I think that the us of the funnel has also made it easier to perform a true "no touch" technique ( potentially decreasing the incidence of breast implant encapsulation).Also, personally, I think the advantages of the infraareolar incision far outweigh any theoretical disadvantages. These advantages include proximity to the planned dual plane submuscular pocket dissection, relatively hidden/forgiving location of scarring, coverage by clothing/swimming suit etc.Patients undergoing breast augmentation surgery should understand, that regardless of the incision used, that scar revision surgery is sometimes necessary to improve their outcome. I hope this helps.
Most PS will cover the nipple and areola with a plastic barrier to prevent bacterial contamination at the time of surgery when they use the crease incision. The PA approach scar can be very difficult to see bur other times it is obvious. The fold incision is not visible unless you are lying down. This scar fades and is not obvious just like the PA scar. Most surgeons prefer the fold incision for surgery.
