- INCISION SITE
The three main incision options are the
inframammary crease (under the breast
where it meets the chest), periareolar
(around the nipple) and transaxillary
(inside the armpit).Inframammary
The inframammary incision is by far
the most common breast augmentation
incision used today, made in the
crease under the breast close to the
inframammary fold. The surgeon creates
a pocket for the breast implant, which
is slid up through the incision, then
positioned behind the nipple.
This incision offers the best exposurefor visualisation and allows the implant
to be placed over, partially under or
completely under the chest wall muscle.
The scar is hidden in the crease under
the breast.Periareolar
For the periareolar incision, an incision
is made just beyond the areola, which
is the darker area of skin surrounding
the nipple. The incision should be
made at the very edge of the areola
where the dark tissue meets the lighter
breast tissue, which makes the scar
least visible.
Similar to the inframammary incision,
the periareolar incision allows the
surgeon to work close to the breast.
It is possible for the surgeon to easily
and precisely place the breast implants
in various positions in relation to the
chest muscle. However, this is the only
incision that involves cutting through
breast tissue and ducts, and sensitivity
in the nipple may be reduced.Transaxillary
The transaxillary incision is made
in the natural crease of the armpit
and a channel is created down to the
breast. This may be performed with an
endoscope (a small tube with a surgical
light and camera in the end) to provide
visibility. The implant is inserted and
moved through the channel into a
prepared pocket.
The greatest advantage of an
underarm breast augmentation incision
is that no scar is left on the breasts. The
scar is virtually invisible in the armpit
fold and lack of tension generally makes
for straightforward healing.
The transaxillary site is relatively
far from the breast, where the surgeon
needs to create a pocket for the implant,
so visibility is limited. There is also a
higher incidence of the implant being
positioned too high and a greater risk of
breast asymmetry after surgery.surgeons also believe it offers them
greater control over the ultimate shape
of the breast.
Round implants come in smooth and
textured shells, but anatomical implants
have textured surfaces only to allow for
better integration with the surrounding
breast tissue. The implant may still flip
or move and distort the appearance
of the breast, so the surgeon must be
experienced with this type of implant.
The polyurethane foam coated
implant provides a texture specifically
designed to reduce rates of capsular
contracture. The foam coating means
the collagen fibres around the implant
do not line up, and are less likely to
slide over each other and contract.
Instead, the fibres assemble in a circular
pattern around the foam and are unable
to form a hardened capsule. There are
some differences in the surgical plan of
foam-coated implants; for example the
pocket size generally needs to be bigger
than usual.
Regardless of the type of implant
women choose, the shape, texture and
size can be customised to reflect her
individual body type and aesthetic goals.F
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