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There are four common choices for the
placement of breast implants.
Placement through the belly button
claims to eliminate any scarring in the area of the breast. I think
that this is a bad choice because it is difficult to impossible to
insure that the implant is actually covered by muscle.
Placement through the armpit leaves
small but visible scars which can be seen when you raise your
arms. While this may be acceptable to many people, the real question
mark with this operation is that at least two papers have shown
that there may be a higher possibility of permanent loss
of feeling in the nipples.
Placing the incision in the fold under
the breast is okay, but when lying down, wearing a halter top or a
bikini, the scar can be visible. The surrounding skin is all one color
and the scars often quite apparent.
I favor placing implants through
an incision made at the lower edge of the areola in most cases. As the
implant is placed empty and inflated after putting it in, the incision
that you need to make is small. There is a natural color change
where the areola changes to breast skin. This usually hides the
scar well.
While there is no RIGHT answer to this
question, and nobody is WRONG for choosing any of the above incisions,
for the above reasons almost all of my breast implants are placed
through peri-areolar incisions.
Placing them over the muscle is also
not a good idea in my opinion. The muscle coverage helps support them
from sagging, hides the edges and leaves a more natural looking
breast. They do ride a little high when first placed, but after the
pectoralis muscle accommodates, they look better for the rest of your
life. This is one area where instant gratification is not best
for long term results. With a little patience, the implants will drop
into place and look quite natural in most cases.
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