With periareolar breast augmentation surgery, I make an incision at the lower border of the areola, 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.
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 northern 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. 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.
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, it which case it is harder to hide the scar. Patients who place particular importance on the ability to breast feed should be aware that there are some less than ideal studies that suggest that the periareolar incision is more likely to interfere with breast feeding.
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.