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.

[Breast augmentation Korea]
Wound/Scar after breast augmentation

There are certain things that patients worry about on breast augmentation in such order,
First, do I really need to do this? How much does it cost?

When the above questions are answered, the patients look for how long the recovery period is.

Finally, they worry about the scar that is caused by the breast augmentation.

Today, I look like to review on the scars that are caused near the inflammatory fold and axillary crease when performing breast augmentation with water drop type implants.
As you have visited my blog and have noticed, the contents here are those that you cannot find on any advertising contents online. I like to blog in order to correct the wrong information that the patients have and ask when they visit the hospitals and also to be a communicating bridge between the surgeon and the patient.

First the scar near the axillary crease disappears after 6 to 12 months.

Breast augmentation Korea KIES-U

This is a photo of the breast augmentation on the axillary crease after 8 months. The wound is becoming lighter without any problems. Maybe the doctors would not realize that a surgery was done on it if they look at it.

Breast augmentation Korea KIES-U

 This is a rare case. This is called hypertropic scar. (It is different from keloid). A hyertropic scar was formed about a year and a half after the surgery. It is difficult to forecast if such a scar would be formed or not in advance.

Breast augmentation Korea KIES-U

This is a picture of the scar after the scar removing injection. The scar is getting lighter but this injection is needed again in the future. I have only seen one of such cases until now.


For your information, there aren’t many who can differentiate hypertropic scar and keloid. Keloid does not have any limitation on the location that it can be formed and it is formed largely without any control. Hypertropic scar can lead to swelling but stays at one position.

A scar from the breast augmentation is rarely a keloid and I have never seen one as of now.

Let’s look at a scar on the inferior breast crease. This scar is different from the one on the armpit in that the scar can be formed on the breast, therefore, this is rather scary. But let’s see if this scar is indeed scary or not.

Capsular contracture Level 3, revision surgery patient Photo after the revision surgery KIES-U

This patient changed the saline type implant and then faced capsular contracture. In the past, the saline type was put through the armpit but the reconstruction was done on the inferior breast crease. As you can see, the incision line is very clear on the inferior breast crease.

6 month after revision surgery It is difficult to find or see any scar from the front view.

Let’s look at another patient’s photo.

Breast augmentation Korea KIES-U

The above and below photos are those of a foreign patient. She did not like the size of the implants and therefore wanted to change then. This is a phots taken after 6 months, and as you can see, there are no scars that you can see from the front view.

Breast augmentation Korea KIES-U

Scars cannot be seen easily from the side view as well.

Breast augmentation Korea KIES-U

 The scars can only be seen if the patient cups her breasts to make the scars be shown easily.
(Normally, one would not be able to see the scars....)

This is a photo taken 4 months after the surgery. I think that the scars will completely disappear in a year or two.

Inferior breast crease scar is more advantageous when you go swimming. It is a place that the swimming suit always covers. In fact, the armpit would be more suspicious to others if you go swimming.

If you are the one who likes public bath, then you might be worried about the inferior breast crease. But you would have to lie down on the ground for anyone to see and notice the scar.

A scar cannot be a decision making factor. The surgeons agree that the major claims after the surgery are shape, symmetry, and volume. There are very rare number of patients who are unsatisfied with the scar.

Today we looked at the scar formed from the best method, inferior breast crease incision, with the help of different photos..
Have a nice day. Thank you.