Will There Be a Scar?
Our preference is always to offer the most suitable surgical approach that best matches you and your desired outcome.
What Can Be Done?
Most patients are concerned about scars that may be visible after surgery. For this reason the incisions are placed in as hidden a position as is possible, but still allowing excellent access for the creation of the implant pocket.
Over the years, the 3 best options are:
The Fold Under The Breast (Inframammary)
My preferred incision is in the fold under the breast, known as inframammary. This is well hidden, heals very well with usually a very hard to find scar. While it gives excellent access to create both the subpectoral and prepectoral implant pockets it also requires the least dissection and therefore disturbance to the body. The incision in my hands is around 5 centimetres long.
It is not suitable however in patients with a strong predisposition to thick scars or those with healing problems, such as heavy smokers.
The Armpit (Transaxillary)
There are patients who are more suited to an incision in the armpit, known as transaxillary, in particular those with a predisposition to thick or hypertrophic scars, such as those of Asian descent, especially if they already have a bad scar elsewhere on the body (such as an appendix or Caesarean scar).
In heavy smokers, I prefer to go through the armpit as should there be wound healing problems (Nicotine slows or stops wound healing) then breakdown of the wound does not automatically mean an exposed implant as there is about 10 centimetres between the incision and the implant.
Exposure of the implant may be the case in the inframammary approach if there is wound breakdown or nonhealing.
The Nipple ( Periareolar or Transareolar)
The periareolar, transareolar, or through the nipple areola complex incision, is favoured by some surgeons and can give excellent results. However when things don’t go as planned, this incision gives the most problem.
If the areola is small and the implant relatively large there is always a risk of tearing of the skin outside the areola with subsequent uncorrectable scarring. As well, there is an increased risk of problems with breast feeding, feeling and even blood supply.