Breast augmentation continues to be one of the most popular plastic surgery procedures with over 300,000 women undergoing the procedure last year. With the return of silicone gel breast implants, in addition to existing saline breast implants, women now have two good choices for their breast augmentation procedure. Whether saline or silicone gel breast implants are ‘better’ for any single patient depends on a thorough knowledge of each implant type’s advantages and disadvantages.
Regardless of whether one chooses saline or silicone gel breast implants, every breast augmentation procedure requires a scar to be created somewhere. The choices for the incision location are either the armpit, nipple, under the breast, or the belly button. In my practice, the incision choices narrow down to either the armpit (for saline breast implants) or under the breast (for silicone breast implants). While I have always enjoyed the armpit (axillary) approach for saline breast implants, and I have never had to do a single scar revision with this approach and it certainly is hard to impossible to find later, I have come to really appreciate the scar under the breast (inframammary crease) with silicone gel breast implants. I have observed this is certainly a great place to put the scar, particularly with silicone gel breast implants which require a slightly longer incision. Since the breast usually hangs over the inframmary crease in most patients, it is really difficult to see. My patients are extremely happy with this approach even though the scar will have some potential redness and unevenness in the very beginning, which is normal.
Using the nipple incision approach is difficult in many women because there is often quite a mismatch in nipple size and desired size of the breast implant that the patient wants. This makes it virtually impossible to put the proper size of breast implant through such a small incision area. Furthermore, the brown color of the nipple (areolar) margin can make even a well-healed scar look noticeable with its whiter color.
Both armpit and under the breast scars heal well, making them really ‘non-visible scar’ techniques for breast augmentation.
Dr Barry Eppley