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Breast Augmentation: 4 Incision Options

There are many reasons that women seek breast augmentation. Some women who seek breast augmentation have small breasts and want to balance out their figures.

Others have lost breast tissue simply by aging or childbirth, and some would like to correct breast asymmetry which may be congenital. In some cases if a woman has lost a lot of breast tissue and does not like the appearance of their breasts she may require a lift in addition to breast implants.

Implants can be placed above or below the muscle. I think this is the most important decision. The best place for the implant will be decided by you and your doctor and will depend on several factors: the appearance of their breasts at the time of consultation, size of implant to be used and Desired outcome / expected.

Generally speaking, when the implant is placed over the muscle, the recovery time will be slightly less than when placed under the muscle.

There are four possible incisions that can be used to put implants in his pocket selected:

1. Peri-areola-Areolar: Through an incision around the areola (the outside edge of your nipple)
2. Inframammary: In the fold under the breast tissue,
3. Transaxillary: With the axilla / armpit,
4. Trans-Umbilical: Through the belly button.

When I place implants in through the belly button or armpit I use and endoscope which gives me the exact placement allowing viewing area on a video screen while I'm working. This makes the actual procedure quicker and patients have little or no bruising after surgery. The recovery time also decreases when using an endoscope as there is no ripping and tearing of muscle and tissue.

Peri-areolar approach-areolar:

The incision is usually around the bottom or lower the skin of the areola skin where it joins the chest. The implants can be placed in a pocket above or below the muscle. When this incision heals well there will be a thin white line that is hard to detect on examination. No increased loss of sensation to the nipple when using this approach. This incision is always hidden unless you show someone.

Inframammary Approach:

The incision is placed in the fold under the breast or just above the fold. The implant can be placed in a pocket above or below the muscle. This incision gives better access to breast tissue and necessarily used in cases of congenital or developmental deformity. When this incision heals well be a fine line that is hard to detect upon examination of the chest. This incision is always hidden unless you show someone.

Trans-Axillary Approcah:

This approach uses a pre-existing crease in the armpit. The implant is placed in a sub-muscular pocket as often as possible with this approach. This approach has been around a long time but has been revolutionized by the use of an endoscope.

The endoscope provides visualization of the sub-muscular pocket considering the exact placement of the implant of little or no bruising in ninety percent of cases. When the incision is virtually invisible cure. There is no increase in infection with this approach.

Trans-Umbilical Approach:

This is also referred to as the TUBA procedure. The TUBA stands for increased trans-umbilical breast. This technique has been slow to catch on but in the right patient works well. The implants can be placed under the muscle or over the muscle.

The rate of the mal-position of the implant in the sub-muscular pocket about 15%. I prefer to go above the muscle when using this technique. Recovery is rapid and in most cases there is very little bruising.

Breast augmentation is ideally under general anesthesia. It can be done under local anesthesia but the procedure takes longer and there is an increased risk of bleeding complications. The procedure takes anywhere from 30 minutes to an hour to perform. Implants placed in the sub-muscular pocket fitted up for two to four weeks.

Most patients who have the procedure done on Thursday can return to work by Monday or Tuesday of next week. Will most likely be sore and tired but still able to perform normal duties. The implants will feel firm for a couple of months what is the procedure and you should see your final result in about three months.

The size may be difficult for patients to understand and figure out implants does not come from cup sizes but rather in different volumes or cc. If two friends are the same size implants but start out with different amounts of breast tissue, they will end up different sizes. We approach this issue by measuring the width of the chest and choosing an implant of similar diameter.

Then we try to implant the patient on that rate to get an idea on size and volume. This is only a rough estimate but helps the patient to translate the volume size. We also offer photography services during the sizing appointment so patients can take home their possible "after" photos to see what size they like best.