Breast augmentation can be done through several different incisions. There are generally 3 different incisions are utilized.
Breast augmentation with the incision under the breast:
This is by far the most common incision used for breast augmentation. This is most well tolerated by women. Women wish to have minimal scars and the base of the breast as the most minimal of scars. This also gives great access and visualization to the surgeon to be able to see all the anatomic elements under the breast and the muscle to give the best-shaped breast and to get the implant into the most optimal position. I found throughout my career that women like this scar the best and have the least problem with the scar. The scar is hidden under the brassiere and is hidden under the bikini wear as well. The incision is not exactly on the base of the breast is slightly up on the breast, so it does not show even if you lift your arm up and do your bra or your bikini rises a little bit. As a result, this does not show much at all on the parts of the breasts that are normally exposed. This is the incision that most women wished.
Breast augmentation with the incision around the nipple:
The incision around the nipple some think is more favorable because it is no incision under the breast or under the arm or any place on the breast at all. However, the incision around the nipple requires a surgeon to go directly through the areolar complex down through the breast tissue and through the muscle. This can cause internal scarring of the breast and causes the breast tissue to be manipulated surgically which causes scarring and future mammograms. This can be done and Dr. Jacobsen is able to perform this and occasionally performs for various anatomic or technical reasons but for the most part Dr. Jacobsen does not recommend this operation for breast augmentation. This incision is more apparent when the naked breast is observed because it is to central focus point of the observation of the breast around the nipple. Generally, the incision under the breast is not nearly as visible when reviewing the breast straight on.
Breast augmentation with the incision under the arm:
Dr. Jacobsen has done many times the incision under the arm operative breast augmentation. This is called the axillary incision or the underarm incision. Dr. Jacobsen has found some women that have had this underarm incision in his experience are not happy with his incision. The scar does show at times even when you are dressed. As a result, when you lift up your arm up there is generally a scar there that can be seen by an observer. Although the advantage is that there is no incision at all on the breast itself there is an incision under the arm. Also the underarm incision requires a surgeon to use various surgical instruments to place the implant under the muscle. As a result, the anatomic elements are not directly visualized for the most part and as a result in Dr. Jacobsen opinion the shape of the breast cannot be tactically manipulated adequately to give an optimal nice shape to the breast. Dr. Jacobsen does not recommend this technique as the incision is not significantly better and at times can be more distracting to an observer and the quality of the shape of the breast is somewhat compromised.
Breast augmentation with the incision around the belly button:
This incision is through the belly button creating a tunnel then from the belly button up to the breast implant and placing then the breast implant through a tubular surgical instrument up under the breast. This was intended to avoid any incision on the breast. Some surgeons are very good at this and do this frequently, but it is an infrequently utilized incision. The downside of this incision is that the belly button now has a significant scar around it. With modern fashionable clothing the belly button is exposed, and this incision sometimes is quite noticeable rather than a small incision on the breast which is normally hidden. This is intended to leave no scar in the breast to allow the breast to look better however this technique does not allow sophisticated placement of the breast implant and dissection of the muscle and soft tissue to give a perfect pocket and idealized shape to the breast. The breast implant is essentially pushed through a tube up into under the breast and then manipulated by pushing the implant around under the breast until it’s in a favorable position. This does not allow sophisticated favorable positioning of the breast implant. As a result, Dr. Jacobsen does not utilize this technique.
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