Possible to Do Silicone Breast Augmentation Via Periareolar Incision?

I was looking to get a breast aug with silicone implants of 300ccs. When I went to the plastic surgeon today for my initial consultation, the surgeon informed me that it would not be possible to do the breast aug with the periareolar incision due to the asymmetry of my areolas. I was wondering if this really is a problem (the asymmetry of my areolas), or if it was just this specific surgeon that is unqualified for it. I really don't want to do a under the breast incision. Thanks.

Doctor Answers 26

Periareolar Incision for Breast Augmentation

This is a good question.

Silicone implants are commonly placed through areola as the transition from the areola to the natural skin tends to hide the incision.

From your pictures you seem like you would be a very good candidate for a periareolar breast augmentation.

I would recommend getting a second opinion from a board certified plastic surgeon.

Austin Plastic Surgeon
4.9 out of 5 stars 123 reviews

Visit a PS

These opinions differ from one surgeon to another.  based on the photos, a periareolar incision would be feasible but you could also consider an inframammary approach.  Visit other board-certified plastic surgeons if you don't feel satisfied with your first visit. Best of luck. Dr. Michael Omidi.

An in-person exam with a board-certified plastic surgeon is the best way to assess your needs and provide true medical advice.

Michael M. Omidi, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 95 reviews

Possible to do periareolar approach

Based on your photos, you would probably be suitable for the periareolar approach since your areolae are large enough. Perhaps you can see another experienced board certified plastic surgeon for a second opinion.

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 179 reviews

Periareolar Incision for Silicone Implants

From your photos, a periareolar approach is reasonable could be used to make your areaolas more symmetric; however you should be aware that there is a higher risk of capsular contracture and not being able to breast feed with this approach. A inframammary approach would probably be the safest with least risk of complications.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 157 reviews

Infraareolar Incision Possible for 300cc Silicone Breast Implants

Thank you for your email question.From your photographs it appears that your areolae are large enough to accommodate a periareolar or infraareolar breast implant incision which would allow placement of 300 cc silicone gel implants through a Keller funnel. The Keller Funnel should be used to place the implant as it protects the skin.

Many plastic surgeons prefer to place silicone gel implants through an inframammary crease incision because this incision is typically larger than a periareolar incision and placement of the silicon gel implant is easier through the inframammary crease approach.

Be sure to consult a plastic surgeon who is certified by the American Board of Plastic Surgery who is experienced in cosmetic breast surgery.

Periareolar incision for breast augmentation

Based on the photos you should be able to have a perioareolar incision for breast augmentation. The determining factor whether you can have a periareolar incision is based on the diameter of your nipple areolar complex. If it is a reasonable size diameter, then you should be able to have the periareolar incision. If it is too small, then it would not be recommended.  Your plastic surgeon should be able to determine this based on the examination and measurements. The asymmetry of your areolar is not the limiting factor. It's just that the asymmetry of the areolar will not be corrected after you have your breast augmentation.

Kim-Chi Vu, MD
Portland Plastic Surgeon
5.0 out of 5 stars 8 reviews

Incision for Breast Augmentation?

Thank you for the question. I think you will have an excellent result with an infraareola incision.  This should not be a problem using saline or silicone gel implants. I agree with you that this tends to be an excellent incision choice. 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. Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

Periarerolar incision for augmentation

You certainly can have a periareolar incision if you choose .  There is enough size to place a full sized  silicone  implant through the periareolar scar.  There may be some assymetries to your areolae, but then no one is totally even and symmetric and this should not be a big issue for you.  The most popular incision is the inframammary incision, but the periareolar  incision may be asked for  almost as frequently. You may want to get a second opinion if your Plastic Surgeon says that it is not possible for you to have the periareolar incision technique.  I believe you may be a candidate for this, but a full examination would always be necessary to tell this for certain.


Good Luck.


Frank Rieger M.D.  Plastic Surgeon

Periareolar approach.

Analizyng your photographs, I think your breast augmentation surgery can be performed via the periareolar approach; yor areola diameter is larger enough for this option. Infra-mamary incision can be another option, and depending on breast implant size selected, probably the inframmary aproach wolud be less noticeable than a periareolar incision (f.e. in a gym).


Enrique Etxeberria, MD
Spain Plastic Surgeon
5.0 out of 5 stars 7 reviews

There should be no problem performing a silicone augmenation through your areolae

The size of your areoale should allow placement of a silicon brest implant through a peri-areaolar incision.

W. Tracy Hankins, MD
Henderson Plastic Surgeon
4.9 out of 5 stars 299 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.