What type of incision and implants should I choose?

Hello. I want to get breast implants but I'm worried about problems like lake of sensation in nipple and breast, breast feeding problems, capsular contracture and rippling. To minimize the risk of having any of those what kind of incision and what kind of implants should I choose? I'm 19. I weight 152 & height 5"9' and I don't have any health problems. I also have a small areola and little breast tissue. Thanks

Doctor Answers 12


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You need to see a PS in person for a thorough consultation.  There's  a lot to discuss and it would be too difficult to explain it all here.

Toronto Plastic Surgeon
5.0 out of 5 stars 35 reviews

Implants and incision

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I always recommend small round textured silicone gel implants placed retro-pectoral since they look and feel more natural, are more stable, less likely to ripple or have complications needing revision. If your breasts are not drooping I recommend an inframammary incision. If you need a simultaneous lift then I recommend a circumareola approach.

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Great question!

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This is a great question because it outlines all of the correct questions to ask during a consultation. I would like to focus on incision placement because I am asked this question at almost every consultation for breast augmentation. 

As we all know there are typically three approaches; the inframammary fold (most common), periareolar, and the trans axillary (endoscopic approach). There is no verifiable clinical evidence that any of these approaches are more prone to changes in nipple sensation. The choice is typically made based on surgeon and patient preference. Personally, in small-breasted woman with poor or non existent inframammary folds, I prefer the trans axillary approach or the periareolar since it is difficult to predict exactly where the fold will end up after the breast augmentation heals. When the incision is not exactly in the fold, the final appearance is somewhat compromised. 

There is some evidence that capsular contracture is more common in the periareolar approach possibly due to micro contamination of the implant with bacteria that normally exists in the nipple area, making the trans axillary (arm pit) approach somewhat more desirable. Generally speaking, most surgeons will do what they have the most experience with so it is important to ask questions and feel comfortable with your surgeon before you book your surgery.

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Incision, pocket, implant questions

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In general, I recommend an infra-mammary incision located in the crease of the breast. This incision gives great exposure to the pectoralis muscle.

A subpectoral pocket will make the implant less noticeable and more natural. The muscle protects the implant and decreases the incidence of capsular contracture. (hard breasts)

The implant choices are saline or silicone. Silicone may be more natural in patients with less breast tissue.

Best wishes!

George C. Peck, Jr, MD
West Orange Plastic Surgeon
4.8 out of 5 stars 25 reviews


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You may very we'll be a candidate for the TUBA procedure. Trans Umbilical Breast Augmentation is the most technically challenging Breast augmentation procedure with few surgeons mastering this technique.  You avoid any visible incisions as saline implants are placed under the muscle. You would need to have an examination to see if you are indeed a candidate. 

Kevin Tehrani, MD, FACS
New York Plastic Surgeon
4.7 out of 5 stars 112 reviews

Breast implants

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Thank you for your question.

To best help you a physical evaluation is required or the view of pictures in order to determine which technique soothes you best. You can choose from different types and sized as well as textures during your consultation.

Jaime Campos Leon, MD
Mexico Plastic Surgeon
4.4 out of 5 stars 257 reviews

Breast Augmentation Options

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Breast augmentation is always a balance between the positives and the negatives of each option, incision location, implant style, implant location and implant size.

You will only be able to use saline implants at your age. You need to have a comprehensive consultation with a plastic surgeon who can answer all of your questions to your satisfaction. You will find that there are certain things that you will want as high priorities and some that you will be willing to compromise on. The one thing you shopuldn't compromise if quality.

John P. Stratis, MD
Harrisburg Plastic Surgeon
4.5 out of 5 stars 37 reviews

What type of incision and implants should I choose?

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Thank you for your question, lack of sensation in nipple and breast are complications less likely to happen, however capsular contracture and rippling are a little more common, medication can be prescribed to avoid these type of complications providing there's an appropriate after care. There's always the possibility of complications, like any surgery.

Salvador Pantoja, MD
Mexico Plastic Surgeon

What type of incision and implants in a 19 year old.

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First, congratulations on your decision and it's great that you are asking questions.  A small inframammary incision has the lowest complication rate, especially regarding nipple sensation and capsular contracture.  You want a sub-muscular augment for several reasons.  As someone under the age of 22, saline implants are your only option right now.  Finally, breast augmentation will not affect your ability to breastfeed.  Choose your surgeon wisely, ask to see pictures and try on implants.  And remember, sometimes you get what you pay for.  Younger patients are sometimes very cost driven and least expensive is often just that for a reason.  Good Luck!

All surgery has risks

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To avoid the risks, don't have surgery. All surgery has risks, find a good plastic surgeon who you can talk to and who will answer all of your questions. Each of us has a slightly different approach and technique. I think that smooth implants place through a circumareolar incision are the best.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.2 out of 5 stars 12 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.