After areolar breast augmentation, the breast implants are in good position and the scars are at the lower border of the areolas.
Breast augmentation can also be performed though a half-circle incision on the lower edge of the areola (the dark skin that encircles the nipple).
This technique is commonly called periareolar breast augmentation.
This scar will fade and is usually well hidden at the transition between areolar tissue and skin. However, on direct view of the breast this scar is usually visible.
After the incision is made, the surgery is taken through the fat and breast tissue layers to the lower, outer border of the pectoralis major muscle.
If the breast implants are to be placed under the muscle, the
Areolar Breast Augmentation In Portland
Placement of breast implants through an areolar incision is the second most common breast augmentation technique used in Oregon, Washington and nationwide.
In our practice, since few patients request this technique (when they are also presented with the axillary and breast fold approaches); we seldom use this method for routine breast augmentation. In addition, recent scientific data implicates the areolar approach with the highest rate of capsular contracture.
This is likely the case because the areolar and breast tissue contain bacteria and these bacteria can attach to breast implants during implant placement through the areolar. Because of these issues, Dr. Connall now advises his patients to avoid the areolar incision for their breast augmentation surgery.
With periareolar breast augmentation, the breast implant is inserted at the lower edge of the areola. On the left, an empty saline breast implant is placed. The right side shows the space for the implant under the pectoralis major. Note that the pectoralis muscle is cut and "released" at the base of the breast.
Areolar Breast Augmentation And Breast Feeding
The areolar breast augmentation approach is widely used by surgeons and accepted by many patients. However, our experience is that most women are bothered by the idea of having an incision on such a sensitive area of their breasts, and they have concerns about potential poor scarring with this approach.
Also, the areolar approach is associated with a higher likelihood of breast-feeding difficulties, as compared to the other breast augmentation incision sites, so this is often a concern for younger patients. While such associated risks are low and may be acceptable to some, we generally agree with most patients' concerns and usually reserve this approach of breast implant placement for those that are undergoing a simultaneous breast lift.
Breast Implant Placement
The implants are then placed. If saline implants are used, they are filled to the correct volume. (Silicone gel implants come pre-filled and sealed from the manufacturer.) The size, symmetry and shape of the breasts are then assessed. If needed, the patient's back will be raised as in the sitting position and the results will be assessed with the patient "sitting up" (while under general anesthesia). The incisions are closed with dissolvable, hidden sutures. The wounds are covered with tissue glue or tape, gauze and a small clear dressing. Finally, a post-surgical sports bra is placed.
Areolar Breast Augmentation Recovery
The recovery is very similar for all three of the approaches to breast augmentation. The post-surgical pain is similar for all three approaches, as well. This is true because the majority of the pain after breast augmentation is from the manipulation of the muscle and creation of the space for the implant. These maneuvers for creating the space for the implant are nearly identical with all three approaches to breast augmentation. After breast augmentation, no drains, pain pumps, or chest wraps are used—you simply wear a post-op bra, which is similar to a sports bra. You go home a couple of hours after surgery to rest. The day after surgery, you start feeling well and can shower and shampoo and blow-dry your hair. Most patients can return to most of their home and work activities within 5 to 7 days. Some patients return to work in 3 to 4 days after surgery, but this is not recommended. You can perform some exercises three weeks after surgery and you can resume full activity six weeks after surgery. For more information about the surgical experience please see our sections on day of surgery and your recovery.