The most common breast augmentation technique uses the inframammary fold or breast crease as the entry point of implants. For most patients, the incisions fade into a fine, barely noticeable scar about a year after surgery.
Another common approach is the peri-areolar in which a small incision along the lower end of the areola is used, specifically the sharp demarcation between the areola complex and the adjacent normal skin.
For patients who are deemed at increased risk of aggressive scars—such as dark-skinned Asians, Hispanics, and Hispanics—the peri-areolar technique may not be ideal, explains breast augmentation Los Angeles expert Dr. Tarick Smaili.
However, there are other variables, such as the implant size and filler material, that should be taken into account as well to determine the most ideal entry point, says the renowned plastic surgeon.
A possible approach for patients concerned with aggressive scarring is to place the incision within the armpit’s natural skin fold, an area that is innately resistant to aggressive scarring.
In the past, the trans-axillary or “through the armpit” technique rarely used [prefilled] silicone implants that would require longer incisions. Saline implants, meanwhile, were considered the ideal choice because they were only inflated with saltwater solution once inside the breast pocket.
But with the introduction of Keller Funnel, a cone-shaped device that is squeezed to push the implant forward into the pocket, it has become easier to use silicone implants via trans-axillary approach. With this technique, there is no visible scar on the breast skin and the patients enjoy a more natural shape and feel.
Meanwhile, patients with a darker skin might also benefit from the inframammary or “through the breast crease” without having to worry about visible scars. But this is only true for women with a defined or deep fold or some slight sagging, which can hide any potential scar.
Another possible compromise is to position the scars on the underside of the bulge of the lower pole so they remain hidden even when the patient’s bikini top accidentally rides higher.
Aside from choosing the correct entry point based on the patient’s anatomy and propensity to thick scars, proper wound care and scar treatments such as silicone sheets and creams can further lead to finer, less noticeable scars.
And lastly, the “premature” scars should not be exposed to the sun for up to a year postop to prevent hyperpigmentation or hypopigmentation (i.e., abnormal pigmentation of the skin due to the effects of ultraviolet radiation).