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Questions about Breast Augmentation?
Visit our website dedicated to information on Breast Augmentation. Find more information about breast implants, breast augmentation recovery, fat grafting to the breast and costs.
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Incision Location for Breast Augmentation
In our practice, we use the infra-mammary, per-areolar and axillary incisions for breast augmentation. Either a saline implants or silicone implants can be placed through the three types of breast augmentation incision locations, with some limitations that we'll discuss below. The recovery time for breast augmentation is about the same for each incision type. Let's look at each of the three breast augmentation approaches in detail.
The infra-mammary incision
The Infra-mammary incision is made under the fold of the breast. It is designed to rest directly into the fold of the breast, which helps conceal it. The main advantage to an infra-mammary incision is that it provides the most direct access to the sub-pectoral space, where most implants are placed. Within reason, any sized saline or silicone implant can be placed through an infra-mammary incision. The location of this incision provides easy access for future implant replacement or other revisional breast surgery. The infra-mammary incision also has the lowest rate of capsular contracture (scarring around an implant). When properly placed, the infra-mammary incision rests in the fold beneath the breast, and is only visible when unclothed, with hands held above the level of the head. The incision is well concealed beneath a bikini top or bra.
Infra-mammary scar 6 months post-operatively
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The peri-areolar incision
The peri-areolar incision takes advantage of the distinct difference in coloration between areolar skin and breast skin. The incision is placed directly on the transition between the two skin tones. The result is a scar that is 'hidden in plain sight'. Because of the minimal tension on this scar, it tends to heal with minimal widening or thickening. The length of the peri-areolar scar limits the size of silicone implant that can be placed through it. In my experience, the maximal volume of silicone implant that can be placed through a peri-areolar incision is about 300 cc. There is no limit to the size of saline implant that can be placed, since the implant is placed 'empty' into the breast, and then filled with saline when it is properly positioned. The peri-areolar incision can be incorporated into a breast lift (mastopexy) pattern for combination mastopexy-augmentation procedures.
The peri-areolar scar in this patient healed well, and is almost invisible at 12 months post-op
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The axillary incision
The axillary (armpit) incision is a less commonly requested, but effective approach for breast implant placement. Scars in the armpit are easily concealed and tend to heal very well. A breast augmentation done through an axillary incision is facilitated by the use of a video-endoscopic retractor, which allows accurate positioning of the implant relative to the pectoral muscle. Due to the limited size of incisions that can be made within the confines of the axilla, only smaller silicone implants can be placed. In my experience, silicone implants of 275 cc or less can be placed through axillary incisions. Saline implants of any reasonable size can be placed through an axillary incision.
The umbilical incision
Saline breast implants can be placed through an umbilical incision. The TUBA procedure (which stands for trans-umbilical breast augmentation) has a few problems. The first issue is that only an unfilled saline implant can be placed through the umbilical incision. The second issue is that the preparation of the implant pocket is not done under direct vision. For these reasons, I do not offer the TUBA umbilical breast augmentation procedure in my practice.
Breast Augmentation Photo Gallery
This photo gallery contains representative before and after images of cosmetic breast procedures. Click on any of the thumbnails to enter the slide show. The text accompanying the photos describes the details of the procedures performed.
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Click on thumbnail to begin viewing slide show.
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I am interested! What do I do next?
If you are considering this procedure we encourage you to schedule a consultation with Dr. Gottlieb. During this visit he will listen to your concerns and discuss your options. He will tell you whether you are a suitable candidate for a breast augmentation procedure and inform you of the potential risks of the procedure. There is a great variety in breast shapes and features and each breast implant procedure must be custom tailored for the patient to get the best possible result. You will also have a chance to view before and after photo albums of his patients who have undergone procedures similar to what you are considering.
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