Breast Augmentation Surgery
Breast augmentation surgery is designed to enhance the size and shape of the breasts. During augmentation procedures, the plastic surgeon makes an incision and creates a “pocket” or space for a breast implant. The optimal incision and location of this pocket depends on a woman’s body frame, the size and shape of the implant, the current amount of breast tissue and the desired location of the resulting scar.
There are several types of breast augmentation incisions. An inframammary incision is located under the breast, allowing the plastic surgeon great control and precision in placing the implant while creating a hidden scar. An inframammary incision is ideal for women who want large silicone implants and/or women who want to breastfeed in the future. The potential disadvantage of this incision is the possibility of a dark or thickened scar.

A periareolar (or infraareolar) incision is often used for combination augmentation/mastopexy (breast lift) procedures, or for women with drooping breasts. This incision also allows for precise placement of the implant, but creates a small scar around the areola that can fade across time. Periareolar incisions can cause damage to milk ducts and glands, decreased nipple sensitivity and capsular contracture (a tightened scar or area around the implant which causes the breast to feel hard).

Some surgeons use a transaxillary (arm pit) incision in order to minimize visible breast scarring and impact on milk production. This procedure can cause temporary pain and a thickened scar, and is not ideal for women who wish to use a large silicone implant.

A transumbilical (TUBA) incision is best for women who want to avoid any visible breast scars. Many surgeons avoid using TUBA incisions because the breast tissue can be disrupted and damaged as the implant is moved into position. Precise placement of the implant may also be challenging. The small TUBA incision is not idea for silicone implants.

Breast implants can be placed above, partially behind, or completely behind the pectoral muscles. Placing breast implants under the muscle (submuscular) provides the most natural looking and long lasting results, and limits damage to milk ducts and glands. In addition, submuscular implants typically do not interfere with future mammogram procedures. The major drawback to submuscular placement is the increased recovery time after surgery.


 

 

What to expect during a consultation for breast augmentation
During a consultation, the plastic surgeon will ask a potential patient her reasons for wanting surgery, as well as her expectations regarding the results. In addition, the surgeon will ask about the woman’s medical history (e.g., current and previous diseases; allergies; current medications; substance use; previous surgeries; family history of breast cancer). The surgeon will also examine the woman’s breasts in order to determine their size, shape and symmetry; skin quality, and placement of the nipples. The surgeon may also take “before” photographs. At the end of the consultation, different breast augmentation options and treatment recommendations will be discussed, including any potential risks or complications related to the procedure.