There are three options here.  An incision can be made in the fold under the breast (inframammary approach), at the junction of the areola and surrounding skin (periareolar approach), or in the armpit (transaxillary approach). This is primarily a matter of personal preference, although in cases where the fold under the breast may need to be adjusted the transaxillary approach is discouraged as it is more difficult to reach the fold from this position.

Introduction

There are many reasons to get breast implants, many of which are discussed here.  No matter why you are interested in breast augmentation this is a very exciting decision, and it is our pleasure to provide some background information to help you think about your options. Everyone considering breast augmentation has to make three basic choices.  They are of equal importance, and there are no right or wrong answers.  Ultimately, you should meet with your surgeon to design a personalized approach.  We have outlined these choices here as “The Three Questions of Breast Augmentation.”

What kind of implant is right for you?

For the past several years, there have been two basic types of breast implants available: silicone and saline.  Silicone gel implants consist of a thin silicone shell filled with silicone gel. Saline implants also have a thin silicone shell, but they are filled with saline solution (salt water). While there are other subtle differences between these two types of implant that we can discuss in detail at your consultation, advantages of silicone implants include a more natural feel and appearance (less likely to have visible “rippling”). An advantage of saline implants is that they can be inserted through a smaller incision than silicone implants since saline implants are rolled up for insertion and filled with saline once inside the breast.  They can also be favorable from a cost perspective.

Recently, a new implant has entered the scene, the Ideal implant.  The Ideal implant is designed to offer a feel and appearance similar to a silicone implant while being filled with saline.  This is accomplished with a sophisticated design that incorporates two saline-filled chambers.

What is the best position for the implant?

There are two possibilities: “under the muscle” and “over the muscle.” The muscle in question here is the pectoralis major, which plays a role in arm motion.  Advantages of placing the implant under the muscle include a more natural feel and decreased likelihood of noticeable rippling or scalloping. Placing the implant over the muscle may lead to an increased risk of visibility and more noticeable rippling or scalloping. In women with a fair amount of their own breast tissue, these concerns are less likely to be an issue.

How would you like the implant to be placed?

There are three options here.  An incision can be made in the fold under the breast (inframammary approach), at the junction of the areola and surrounding skin (periareolar approach), or in the armpit (transaxillary approach). This is primarily a matter of personal preference, although in cases where the fold under the breast may need to be adjusted the transaxillary approach is discouraged as it is more difficult to reach the fold from this position.

Next Steps

We would be happy to see you in our office to discuss your specific case and design a customized treatment plan. Please also see this page for examples of breast augmentations performed by the practice. Appointments can be made by using the contact form above or by calling 212-520-1129.

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