Despite numerous advances in breast augmentation techniques over the past several decades, it’s inevitable that plastic surgery will result in scarring somewhere on the body. Every year, over 300,000 women who make decisions about their augmentation – including implant type, size, and placement – must also decide where the knife may fall. A recent feature in New You has highlighted this dilemma, along with some techniques that plastic surgeons sometimes use to minimize and conceal the appearance of scarring.
One of the rarest techniques, known as the intra-areolar incision, avoids breast scarring by cutting the areola, which is the dark area surrounding the nipple. Leonard A. Rubenstein, a cosmetic surgeon who pioneered the technique, says that “this skin doesn’t form scars like normal skin because there are fewer sweat glands and less fat in the tissue.” However, many other surgeons warn that this technique requires an experienced surgeon, and that scarring can still result.
Fortunately, there are alternatives that bypass the breast altogether, which is crucial for many patients. “Different patients have different definitions of ‘minimal-scar’ surgery,” Dr. Angelo Cuzalina, an Oklahoma cosmetic surgeon, told New You. “But for some women, a scar on the breast just isn’t acceptable.”
One popular technique is the armpit approach, or transaxillary method, when a surgeon makes a small incision in the armpit. The implant can then be pushed to the breast site with the help of an endoscope (small, slender surgical camera). Scarring in the armpit is often more acceptable than scarring on the breast.
With a transumbilical (TUBA) breast augmentation, an incision can be made in the bellybutton, so that the implant can be tunnelled to the breast site. Since the bellybutton is already a scar (from the umbilical cord) and tends to be recessed, the scar created by this incision is almost invisible. However, silicone implants cannot be used, and this surgery may be unsuitable for some patients for other reasons, such as lacking sufficient stomach fat.
A third approach is the transabdominoplasty (TABA) technique, which is performed during tummy tuck surgery. This takes advantage of the incision along the pubic bone that has been created for the tummy tuck. A silicone or saline implant can go through the tummy tuck incision and be pushed to the breast site.
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