At its most basic level breast augmentation is really the same in every woman when it comes to implant options and pocket locations. While all women have various concerns about the choice of implant insertion incisions, in certain ethnicities this concern may be magnified. Such is often the case in women of increased skin pigmentation such as Hispanic, Middle Eastern, African-American and Asian women. Thus the most frequently used location in breast augmentations, the inframamary location, may be aesthetic concern in such patients.
In the July 2018 online issue of the Archives of Plastic Surgery, an article was published entitled ‘Breast augmentation surgery using an inframammary fold incision in Southeast Asian women: Patient-reported outcomes’. In this paper the authors performed a retrospective assessment of twenty-two (22) Asian women who had anatomical silicone gel implant breast augmentation through inframammary incisions using the Breast-Q Augmentation Module as well as the Patient and Observer Scar Assessment Scale (POSAS) between one and five years after their surgery.
Their results showed that the mean Breast-Q satisfaction with breasts (69.2) and psychosocial well-being (84.0) was reasonably high. Evaluation of the scars with the POSAS score was 4.2. Most patients (91%) would recommend the procedure. Patient complaints consisted of asymmetry (9%), sensory in and around the nipple (23%), adverse scarring (18%) and capsular contracture. (5%) No revision surgeries were performed.
This small long-term clinical study supports that Asian breast augmentation through an inframammary incision is associated with a high satisfaction rate. With nearly one-fifth of them expressing some concerns about the resultant scar, however, this seems fairly high. This is why I would always consider the transaxillary approach for implant placement, where now saline and silicone can be equally placed within ‘normal’ implant sizes, to still be my primary incision choice for Asian breast augmentation.
Dr. Barry Eppley
Indianapolis, Indiana