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Implant Procedures

The four most common approaches taken by surgeons when performing breast augmentation are transaxillary, periareolar, inframammary and transumbilical. These names refer to the location where the incision will occur. Each of these procedures have their own advantages and disadvantages. Your surgeon will advise which procedure best suits you.

Transaxillary Augmentation

This is where the incision made for the breast implant is hidden under the armpit. There will be no actual scars on the breasts themselves. Scarring to the armpit is very minimal.

Periareolar Augmentation

Periareolar incision is made on the boarder of the under areola. This is where the darker skin pigmentation of the areola meets the regular colored skin. Scarring can be hidden by the darker skin color of the areola.

Inframammary Augmentation

The Inframammary incision is the most common and reliable method of breast augmentation. The incision is made along the fold or crease of the under breast. The only disadvantage of the Inframammary approach is the slight visible scarring. But this is only noticeable when the patients arms are raised above her head, or in intimate moments. This approach is also makes it easier for re-augmentations or revisions.

Transumbilical Augmentation

This is where a small incision is made in the upper fold of the belly button, and the implants are positioned with the assistance of an endoscope. Although a relatively new approach, it is becoming more popular due to no visible scarring.

Subglandular or Subpectural

The breast implant can be positioned either over the pectoral muscle (subglandular) or under the pectoral muscle (subpectoral) depending on the amount of existing breast tissue and the patients desired outcome.

Advantages of Subglandular

• Easy to position
• Faster recovery time
• Muscles are left intact, so  less post surgery pain
• Cleavage easy more easily created
• Easier access for revision or re-augmentation

Disadvantages of Subglandular

• Rippling is can be more noticeable than subpectural
• More difficult to have breast imaging, mammography
• Capsule Contracture rates are higher in Subglandular placement
• Implants look more rounded than the natural shape you get with under pectoral positioning

Advantages of Subpectural

• Breast implant is covered by the muscle, so rippling is less noticeable
• Subpectural placement does not interfere with breast examinations or imaging
• Lower chance of Capsule Contracture
• Lowers the chance of the implants to sit too low on the chest wall, causing nipple positioning to look to high on the breasts

Disadvantages of Subpectural

• More post surgery discomfort
• Re-augmentation or revision is more difficult as implant is harder to get to
• Surgery and recovery time may take longer

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