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Incision placement in breast enlargement
Posted on March 9th, 2009 4 commentsWhat is the perfect incision placement for breast augmentation ?
Well, there is none. There is different options, the most popular ones being
1.The armpit. This is a very elegant approach, implying the the breast implant is brought in through an incision in the armpit. I personally have used it for quite a while and on very special patient request I still do, but a few points have to be taken into account. Firstly, the skin of the armpit can impossibly be made sterile, so there is a higher risk of infection, secondly, I have had patients who, after axilar breast enlargement, reported certain restrictions in movement to me. This has to be taken into account.
2.The nipple. In planning breast enlargement, I guess half of the patient is very keen to have their incision through the nipple and half are terrified just by the thought of that. there are really very different views on that. Since I personally only use cohesive gel implants, a certain size of the nipple is necessar. This does not have to be excessive but should be sufficient to accommodate a 3cm cut along the lower nipple border.The scar will fade with any of the three incisions mentioned, but probably quickest here.
3.The inframammary crease. Great advantage of this incision in breast enlargement is that it heralds the smallest risk of infection, and the inframammary fold can be planned very accurately.Length of incision is normally around 3-4 cm.
Case example from our practice:

Patient with very little breast tissue and small nipple
Athletic, desire for substantial augmentation
Patient requested cohesive gel implants
Therefore nipple no suitable option
Post op resultInframmary, submuscular augmentation
300cc moderate profile round coheisve gel implants
6 months post op inframmary incision not visible
Preoperative A cup, postoperative C-cup
There are some exotic variations like endoscopic approaches through the bellybutton just to name one example, who I feel make restricted sense from the physiological point of view since when placing a foreign body large dissection pathes make the procedure somewhat more risky.
In Spain, breast augmentation remains the most popular aesthetic surgical procedure.



Dr. Alexander Aslani is director and head of the department of Plastic, Aesthetic and Reconstructive surgery of Hospital Quiron Malaga, Spain.
The department is the only one of its kind offering reconstructive microsurgery within the private healthcare sector in Andalucia, and apart from its offices in Hospital Quiron, also offers consultations in private practice in Cirumed Clinic Marbella.
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