*Updated on Tuesday, September 5, 2023

With periareolar breast augmentation surgery at our Chicago practice, I make an incision at the lower border of the areola, which is the colored zone that surrounds the nipple. The scar tends to hide quite well along the line of demarcation between the lighter colored breast skin and the darker tones of the areola.

The areola also is one of the privileged zones of the body in terms of scarring. The eyelid is a similar privileged zone. Even in patients who have personally experienced thicker scars when they have undergone surgery in other zones, the privileged zones tend to heal inconspicuously. Of course, life is never so perfect as to make this a rule that applies without exception, but the exception is rare.

Want to learn more about this technique? Here’s what you should know about periareolar breast augmentation surgery:

What Are Surgical Incisions for Breast Augmentation?

There are many choices you will need to make for breast augmentation, and the area where the surgical incision will be made is one of the main variables to consider. There are three main types of incision: transaxillary (under your arm), inframammary (under your breast), and areolar (around your nipple). The two most common options are periareolar and inframammary.

What Are the Advantages of Periareolar Breast Augmentation?

You may want to consider periareolar breast augmentation surgery if you have ever formed a thick or raised scar or if you have a family history of forming thicker scars. People of African or Asian ancestry have a greater risk of forming thick scars than people of European ancestry, so that may influence your decision.

There are also patients who prefer the periareolar incisions for breast enhancement surgery because the scar hides well along the color transition of the areolar border. The scar from periareolar breast augmentation is well-concealed and virtually invisible. An added benefit is the fact that any breast surgeries done in the future can be handled via this same opening.

In the other two main locations for incisions for breast implant surgery, there is not a clear color transition that helps to hide the scar. With the inframammary incision we rely upon the natural shadow that occurs where the lower curvature of the breast meets the chest wall in order to hide the scar. Some patients do not have a well-defined fold at the base of the breast, and these patients may want to consider the periareolar incision. With the axillary approach for breast augmentation surgery, we rely upon the natural shadow of the arm pit area to hide the scar.

What Are the Disadvantages of Periareolar Breast Augmentation?

There are three situations where a periareolar incision for breast augmentation surgery may have some disadvantages. If the areola is very small, it may be difficult to obtain access for the breast implant, especially if the patient has chosen a silicone gel breast implant. There are also some patients in whom the areolar border is not well-defined, in which case it is harder to hide the scar. Patients who place particular importance on the ability to breastfeed should be aware that there are some less than ideal studies that suggest that the periareolar incision is more likely to interfere with or complicate breastfeeding.

There are several studies that suggest that the periareolar approach to breast implant surgery may be associated with a higher risk of capsular contracture—a thickening and hardening of the scar tissue that naturally forms around any implanted device, including breast implants. This may be related to a greater exposure to the bacteria that naturally live in the ducts of breast tissue.

Breastfeeding and Periareolar Incisions for Breast Augmentation: What You Should Know

Breastfeeding is a major concern for many women who are having implant-based breast surgeries. Most women who have breast augmentation are successfully able to breastfeed, as (in most cases) the surgery won’t affect the ducts or areas that are involved in milk production. Furthermore, breast implants won’t pose any known medical risks to your baby.

However, the type of incision and surgery you have will affect the risk of an augmentation impacting breastfeeding. A periareolar incision can sometimes complicate the nursing process. It may affect the sensation of the nipple and block signals needed for the letdown reflex in breastfeeding. Unfortunately, you won’t know for sure how it is affected until you attempt to breastfeed. If you have had breast augmentation and want to breastfeed, you should do everything possible to promote milk production, such as taking natural supplements.

At the Whole Beauty® Institute we take the time to learn your priorities, medical history, and goals so that we can help you to select the plan for breast augmentation surgery that will work the best for you.

For more information about techniques used for periareolar breast augmentation, contact Chicago’s Whole Beauty® Institute. Call us at 312-751-2112 or fill out a contact form to request a consultation.