Breast Implants Placement and Incision Options – Dr. Charles Perry

Two more important decisions that breast augmentation patients must make is where to place breast implants, either over or under the pectoral (chest) muscle, and what type of incision Dr. Charles Perry of Chrysalis Cosmetics should use during breast enhancement surgery. Both decisions affect the final look of breast implants and should only be made after reviewing the information below and consulting with Dr. Perry.

Subglandular Placement

Subglandular placement is sometimes referred to as "overs" because Dr. Perry positions breast implants over the pectoral muscle and beneath the breast tissue. The principal advantage of subglandular placement is that it tends to be less painful and require less recovery time than submuscular placement. This is because the pectoral muscle is not affected by the overs approach. A note of caution: patients with thin skin, or little body fat or breast tissue, may not be suitable candidates for the subglandular approach because breast implants in this position may be more noticeable through the skin.

Submuscular placement is sometimes referred to as "unders" placement because Dr. Perry places he implants under the pectoral muscle. This breast augmentation approach can be more painful than overs placement, but it delivers more natural-looking results, which is a prime advantage of unders placement.

Another advantage of submuscular placement is that it makes breast imaging easier. With unders placement, it is easier for an MRI or mammogram to distinguish natural breast tissue because breast implants are placed underneath this tissue.

Submuscular placement may also decrease the risk of capsular contracture, a possibly painful condition in which scar tissue forms around breast implants, causing the breasts to feel hard or implants to rupture.

Incisions Options

During consultation, Dr. Perry also reviews the incision options with Sacramento breast augmentation patients. The three principal incision options that Dr. Perry offers are: inframammary, periareolar and transaxillary. Together with Dr. Perry, patients should choose an incision option that best fits their individual body type, aesthetic goals, and the size and type of chosen breast implants. Keep reading for more details about each type of incision.

Inframammary Incisions. With inframammary incisions, Dr. Perry positions each incision in the natural fold of the breast, just above where the rib cage meets the breast. Once Dr. Perry has made the needed incisions, he creates the implant pockets either over or under the pectoral muscle.

Depending on the type of breast implants used, inframammary scars can be as small as 1 to 1 ½ inches long. For instance, Dr. Perry can insert saline implants with a smooth outer shell through a small incision, but he must use a larger incision for silicone gel or textured implants.

Periareolar Incisions. Dr. Perry positions a periareolar incision on the outer edge of each areola, the darker-pigmented skin that surrounds the nipple. He may recommend periareolar incisions for patients who are also undergoing breast lift or would like their areola reduced.

With periareolar incisions, there is a slight chance of decreased sensation in the nipples, but this is typically temporary. This incision approach may make it difficult to breastfeed, so breast augmentation patients who want to have children should be sure to consider this when deciding on an incision method.

Also, those who opt for periareolar incisions have an increased risk of staph infection. This is because staph bacteria may be present in the milk ducts located in the nipple, and these ducts may be incised in this incision approach.

Transaxillary Incisions. Lastly, Dr. Perry can make transaxillary incisions, or incisions located in the armpits. Inserting breast implants through transaxillary incisions can usually be done endoscopically. Dr. Perry creates a tunnel from each incision to the site in each breast where the breast implants will be placed. In general, transaxillary incisions are as small as 1 to 1 ½ inches long, again depending on the type of breast implants. Dr. Perry may recommend this incision approach for patients who desire full submuscular placement.

These important decisions regarding breast implant placement and incision type should not be made lightly. Dr. Perry will discuss the available options with each patient and help her decide which is most appropriate, given her unique anatomy, desires for the outcome of breast augmentation surgery and the characteristics of the chosen breast implants.

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Chrysalis Cosmetics
785 University Avenue
Sacramento, California 95825
Ph. (916) 273-7435
Fx. (916) 760-8218