Breast Augmentation – Scars
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Breast Implants are typically inserted through one of four approaches with resulting scars in the armpit, around the areola, in the crease under the breast, or the umbilicus (belly-button).
When breast implants are placed at the same time as other procedures are performed, the scars can be affected. For example, when breast augmentation is done at the same time as a breast lift (mastopexy) the implants may be inserted through the same scars already used for the breast lift. In fact, in some breast lift cases, the addition of breast implants may actually reduce the scars needed for the procedure. When breast augmentation is done at the same time as the tummy tuck (abdominoplasty), it is possible in some situation to insert the implants from the tummy tuck scar and avoid a scar on or near the breast completely.
How you heal is an issue that is beyond the control of Dr. Newman and may affect the appearance of your scar. Your ability to heal is affected by many factors including nutritional issues. Although nutritional factors can affect your ability to heal, they have never been shown to affect the appearance of the scar that results.
Breast augmentation performed with silicone gel breast implants typically results in longer scars than those resulting when saline-filled implants are used. Saline implants are delivered empty from the manufacturer. They are inserted almost completely and filled after insertion through a small tube allowing a small incision to be used.
Silicone gel-filled implants are delivered from the manufacturer already filled and, therefore, result in a longer surgical scar. Some of the instrumentation used during the procedure such as fiber-optic lighted instruments help Dr. Newman to perform the procedure safely through smaller incisions. These instruments have a bright light shining from their tip and allow Dr. Newman to see clearly inside the breast despite a small incision size.
Dr. Newman’s Opinion
“ Scars resulting from any cosmetic procedure must always be considered as an important factor. In the list of advantages and disadvantages of any procedures, the scars are always on the list of negative factors. How a particular patient will scar is never completely predictable, but it is my opinion that placing a scar in an area hidden by clothing, even a bathing suit or lingerie, is preferable.
“Axillary (armpit) scars typically heal well in many patients but a bad scar in this area can be devastating as it is an area not covered by a bathing suit or tank top. The size of your areola may affect whether this approach may be used. This is more of an issue with silicone gel-filled implants as they are already filled prior to insertion.
“In many patients, one of the factors adding to an asymmetric breast appearance is an asymmetry of the fold beneath the breast. Using the infra-mammary (under the breast) scar allows the best access to this fold for positioning and adjustment.
“For this reason it is my opinion that the infra-mammary approach often has the most advantages. The key to obtaining a good resulting scar in this area is proper placement of the incision within the crease. This is an area of minimal tension that is an advantage for wound healing. In my experience it is very rare to hear a complaint regarding a scar in the infra-mammary location.”
If you are in the New York City, New York area and have questions about breast augmentation scar placement, please contact us at the Advanced Plastic Surgery Center to set up a consultation.