Determining Implant Size and Incisions in Breast Augmentation: Inframammary and Infraareolar

Determining the Right Size Implant for the Patient

The most important clinical factor in determining breast implant size is the base width or diameter of the patient’s native breast. If the patient would like
more volume to obtain a larger cup size, the implant profile can be shifted from a moderate profile implant to higher profile implant. Dr. Hughes will help you
determine the right size implant for you. An implant that is too large for the chest wall will appear to be under the armpit, and the patient will complain of hitting the implant with the arm.

Choosing the Right Incision for the Patient

There are four types of incisions commonly employed in breast augmentation: inframammary, periareolar, transaxillary, and transumbilical.

The inframammary incision permits complete visualization of either the prepectoral or subglandular pocket and allows precise placement of virtually all implants. The technique does leave a visible scar within the inframammary fold of about 5 cm or 2 inches.

The periareolar incision is placed at the areolar-cutaneous juncture and generally heals inconspicuously. The dissection allows easy adjustment of the inframammary fold and direct access to the lower parenchyma for scoring and release when a constricted lower pole present or with a tuberous or tubulous deformity is present. Disadvantages include potentially increased risk of nipple sensitivity changes, visible scarring on the breast mound, and may not allow introduction of larger gel or enhanced cohesive gel implants. Some areolae are simply too small to permit the surgery to be performed through this incision.

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