Breast augmentation – Inframammary fold (Incision and scar)

Anatomical implants are mostly used in breast augmentation today.



Whether you do anatomical augmentation or not, you would choose the type (round cohesive gel or anatomical cohesive gel) and the size of the implant before the breast augmentation. Next you would need to choose on the part for the incision. This is one area that you would think about a lot. I would like to share on this point to help you out.

I would like to refer to very prestigious contents. The two references below are authored by world renowned Dr. Spear and Dr. Tebbetts.



There are two competing goals in breast augmentation; providing comfortable access to the breast, while placing the incision in the most inconspicuous location possible and less exposure of scar. For many surgeons, it is the inframammary fold approach that provides the best balance between these two aspects of incision location. (Surgery of the breast, Scott L. Spear. 2006 Lippincott Williams & Wilkins)




The inframammary approach for breast augmentation is the most widely used incision location for breast augmentation. …. Reasons for popularity of the inframammary approach include direct vision for optimal control, minimal tissue trauma, and minimal bleeding. … Each of these reasons directly impacts patient outcome short and long term. (Augmentation Mammaplasty, John B. Tebbetts, 2010, Elsevier Inc.)

As you can read in the contents above, most surgeons around the world are already aware that the inframammary fold incision for breast augmentation leads to least complication and other problems providing best results. Inframammary fold approach is the most popular one in US, EU, South America.
Also, inframammary fold approach has been getting a lot of attention after the certification and sales of anatomical implants.
It is ideal that inframammary incision is done for the anatomical implants.

However, this approach is not comfortable by many surgeons in Korea. This is because many young patients preferred the axillary crease approach. I have had interest in inframammary fold and have applied it for a long time. I would like to post on some of the strong points of inframammary fold incision.

Below is the summary of different incision methods.






1) Axillary crease



Incision on the axillary crease means that the incision is done far away from the breasts therefore, it is recommended to those who are sensitive about having a scar on their breasts. However, there is no visual so we need to use the endoscope (long surgery time) and the distance from the input to the breast is long, meaning that there is that much more change of damaging the tissue of the entrance path. There can be pain after the surgery due to this cause. There are many nerve and vessel stimulants in the armpit therefore there can be some related symptoms caused. Also, it is not easy to put in form stable anatomical implant through the axillary crease and we need to study more on the possibility of implant rotation.



2) Areola



One thing that worry the patients about the areola incision is that the breast feeding may be disabled because of the areola incision. There is no such problem if an experienced surgeon performs the procedure.
Areola incision is a very good method for most breast augmentation including sagging breast and combination of 2 or more surgical methods.
However, there is a concerning point in which the incision on the breast may lead to tissue penetration causing trauma.

Also, as the implant is put in, the implant can come in touch with skin tissue cell that might lead to infection, inflammation, and even capsular contracture.
If the diameter of the areola is big enough, there would not be much problem with using the anatomical implant for areola incision method.



3) Inframammary fold 



The reason that inframammary fold incision does not cause pain is because it can be desquamated quickly. Also, it has a clear vision therefore the procedure is quick. Pain and complications are caused when there is not much visual and if one needs to damage the skin tissue.
Inframammary fold has best visual compared to any other methods and so it is the safest method as well. There is less trauma and less invasiveness.
Also, desquamation is easy and one can stop bleeding near to 100%. It is the easiest method when using the anatomical implant.
The scar can be covered by the breast skin therefore the scar is not easily visible.



4) Belly button



Belly button method leads to least pain and least visible scar that is far away from the breast. However, it is impossible to use cohesive gel silicone implant for this case. Only the saline bag type can be used. Of course, anatomically shaped cohesive gel implant cannot be used also.

 
Today, we looked at globally used breast augmentation incision method of inframammary fold.

I think that this method will be applied more and more with the usage of anatomical implant.
Also, many doctors believe that it is the safest incision method that can be applied.

Thank you. Have a great day.