If you are considering breast implants, one thing to think about from the very first meeting with your consultant is the important matter of how and where the incisions will be made. Your consultant will discuss the various options with you, and whether each of these would be appropriate for your unique requirements. Every woman is different, and not all of the options will be suited to everyone. However, here is a brief overview of the various incision options, so you can arrive at your clinic appointment well prepared.
There are three main types of incision commonly used by surgeons when inserting breast implants. These are inframammary (at the breast crease), periariolar (at the lower edge of the areola), and transaxillary (under the armpits). All of these options leave minimal scarring, and are located in places where the post surgical scar tissue will be unobtrusive. All three options are available for both saline and silicone implants.
The Inframammary Incison
The inframammary incision is a popular choice amongst women who have had surgery, because the scar is hidden underneath the breast. It will not be visible unless the breast is lifted up. It works best on women who have a pronounced breast crease. Those with a less developed crease will perhaps prefer to consider other options, because the scar tissue may be more visible for them. Some people have found that inframammary scars can be exacerbated by underwear and bikini swimsuits, and this makes them more visible.
However, on the plus side, many surgeons prefer this incision choice because it allows for maximum accuracy when placing your implants, and the incision point can be reused if you later require a revision or removal of your implants.
The Periariolar Incision
The periariolar incision is a good option if you are want to minimise the size of your scar, as long as your chosen implants are relatively small. Understandably, the incision that can be made and disguised by the areola will have to be small, so this limits you to certain types of implant. A potential drawback of an areolar incision is that revision or reversion surgery cannot be undertaken through the original incision. If you did need further surgery, therefore, you may end up with two scars. Some women fear that an areolar incision will reduce sensation and cause problems with breastfeeding. However, research shows that there is an equally low risk of these complications for all the incision options. Another thing to bear in mind is that if your areola are small, any incision may not be big enough to insert the implants, so you may need to make another choice. Research also shows that there is a greater risk of capsular contraction with periariolar incisions than with the other incision methods.
The Transaxillary Incision
Transaxillary incisions leave no scar on or around the breast. However, armpit scars are more routinely exposed. If you need revision surgery, it may not be possible to reuse the transaxillary site, so this may result in additional scarring. Some surgeons find it more difficult to accurately place implants through the transaxillary site. Others use devices called Keller funnels, which do away with this difficulty. Of course, this depends on the size, material and shape of your implants and your existing shape, so only your surgeon can comment with any accuracy.