are three popular incisions in breast augmentation.
According to the patient's status and preferrence, the site of incision
can be decided.
- Transaxillary incision : recommended to primary
surgery and young unmarried woman who has symmetric chest and
Pros: concealed innoticeable scar, easy in submuscular implant
Cons: revealed in swim suit, difficult in revisional surgery,
risk of sensory nerve injury, upward migration of implant
- Inframammary incision : recommended to secondary
surgery and if the patient has asymmetric chest and inframammary
Pros: easy pocket formation and more accrate positioning of implant,
easy revisional surgery
Cons: exposed scar
- Circumareolar incision: recommended in subglandular
(above pectoral muscle) augmentation with saline implant and if
patient has ptotic breast
- Subpectoral (submuscular) : recommended in
thin, slender patients
less demarcation of implant and less chance for contracture
- Subglandular (above pectoral muscle) : recommended
in ptotic breast
less pain and more projection
Deciding the exact size of implant is the key in patient's satisfaction.
According to patient's desired result, chest cage, skin envelope,
skin thickness and breast parenchyma, appropriate size of implant
can be judged.
The standard implant in the United States and Korea has been saline
filled, ever since the FDA moratorium on silicone gel filled breast
implants in 1992.
But nowadays, cohesive silicone gel implant becomes a standard because
of its softness and durability.
The most distinguished features of cohesive silicone gel implant
are its cohesiveness and soft solid gel feel.
If a cohesive implant is cut in half, there is no gross movement
of gel, and the implant maintains its shape.
- 1. It won't leak even after rupture because silicone is crosslinked
- 2. Feel softer than saline implant
- 3. Less chance of capsular contracture
- 4. Less folds or rippling and less chance of implant rupture
- 1. Feel harder than previous silicone implant
- 2. Need more length of incision than saline implant
- 3. Expensive about 1,000 USD
- 4. Need MRI follow-up to detect implant rupture
A 26 year old female underwent breast augmentation using
230 cc cohesive gel implant.
Usually Asians have small chest cage, thin body, tight skin
envelope, tough and inelastic inner structures and prefer modest
So , I prefer tranaxillary or inframammary incision, submuscular
placement, moderate sized cohesive silicone gel implant.
Pocket dissection for implant in Asians is harder.
Endoscope is a special viewing instrument that allows a surgeon
to see images of the body's internal structures.
Because pocket dissection in Asians is harder, endoscopic breast
augmentation is frequently employed.
The risk of sensory loss from nerve damage is decreased and bleeding,
bruising and swelling may be significantly reduced.
In addition, more accurate pocket dissection is possible in tranaxillary
This means you can recover more quickly and return to work earlier
and has less risk of complications like asymmetry, improper positioning,
hematoma and contracture than if you had undergone open surgery.
Under general anesthesia, it will take about 1 or 2 hours.
You're likely to feel sore for a few days following your surgery,
but most of your discomfort can be controlled by medication prescribed.
The stitches will be removed after a week.
You should massage your breast by yourself for 3 months.
Recommended stay : 7 days
Lack of implant permanence -- surgical removal or replacement
of the implants may be required to treat problems such as deflation,
capsular contracture, bleeding or infection. Increase or decrease
in sensitivity of nipples or breast skin, occasionally permanent.