Breast augmentation crease incision technique often results in a 1-4 cm scar concealed by the natural skin fold between the breast and the chest, although some doctors prefer that it lies slightly above the crease but still on the underside bulge of the lower pole for optimal scar concealment.
Despite the popularity of breast augmentation crease incision as it gives doctors the “best and most direct” view, celebrity Los Angeles plastic surgeon Dr. Tarick Smiley says he still personally prefers the peri-areolar or “through the nipple technique,” or the trans-axillary or “through the armpit method” should the patient has a small areolar complex.
In one of Dr. Smiley’s recent Snapchat videos, he says that the scar of breast augmentation crease incision has the tendency to thicken; this is particularly true for women with a strong history of keloid or hypertrophic scarring.
For most patients, the surgeon recommends placing a U-shaped incision precisely at the lower border of the areola so the scar lies within the light-dark skin junction thus it is very well concealed.
Should the patients have small areolas that could make the peri-areolar incision technique not ideal due to increased risk of visible scar, the surgeon says the trans-axillary or armpit site is often considered as a good alternative.
Despite some caveats that come with breast augmentation crease incision, Dr. Smiley says it also offers some advantages: It can be used again in the event of revision surgery; and the implant does not come into contact with breast ducts, which are believed to harbor bacteria.
However, the peri-areolar incision technique can be later used again in the event of revision surgery too; hence, this should not be the only reason to choose breast augmentation crease incision, he believes.
In terms of reducing the risk of implant infection of contamination at the time of surgery, a risk often mentioned when peri-areolar incision technique is utilized, Dr. Smiley says that this can be significantly reduced by irrigating the implant pocket with antibiotics.