In order to place the breast implant, a four to five centimeter long access must be created in one place. Here are several options to choose from, which are described below:
The incision in the breast fold
The so-called inframammary incision is by far the most commonly used. Since it is placed in the crease located below the breast, the fine scar almost does not stand out. This incision offers the surgeon favorable visibility and thus allows the best possible placement of the implants and optimal shaping of the breast. Nerves and milk ducts are spared as far as possible, so that both the sensibility of the breast and any desired breastfeeding function are not impaired. If later replacement of the implants is necessary or wanted, this can be done via the same interface - so there is no need to set another scar.
However, it should be taken into account that the fine scar may be visible in the lying-down condition with the breast exposed. It is also possible that the breast fold over time or in case of heavy weight changes their position a little, which also causes the scar to slide slightly up or down. In the case of very small breasts, which do not form an invagination fold even after surgery, this cut is generally discouraged because of the visible scars.
Conclusion: Due to its many advantages, the inframammary access path is usually the first choice - especially for larger breast implants.
The cut in the armpit
The biggest plus point of the so-called axillary incision is that the breast surface remains completely scar-free and therefore flawless. The fine scar in the armpit is usually barely visible.
However, the field of vision for the operating physician is limited and consequently the shaping of the implant bag is technically very demanding. If one chooses this method, one should turn to a beauty surgeon who is very experienced in this incision and who also works endoscopically (i.e., camera-assisted). The axillary access also allows bacteria to enter the wound area during surgery, which can lead to inflammation.
Conclusion: Especially for small breasts and small implants an aesthetically optimal access, but which requires a lot of skill and thus also carries risks.
The cut around the nipple
In this, also periareolar or perimamiläre mentioned technique, a either semicircular or in the second case circular cut is made around the areola. If wound healing works well, the scar is usually nearly invisible. This method is particularly useful if the nipples in the course of surgery should also be reduced or slightly repositioned. The biggest disadvantage of this cut is that eventually the sensitivity of the nipples and the ability to breastfeed may be limited. Also, some studies have found that the risk of developing capsular contracture is slightly greater than other access routes. Since this technique also usually only relatively small implants can be used depending on the size of the breast, it is not always suitable for all patients.
Conclusion: Optically very good results. Due to various limitations and dangers, the periareolar / perimamilic method is usually chosen only in special cases.
Author: Dr. med. Monika Steiner