Types of Incisions and Types of Placement

Cosmetic Surgery in St. Louis, Missouri

When determining what choices will best suit your needs for breast augmentation, you and your plastic surgeon must discuss each of the options available to you. Dr. Richard L. Kofkoff  prides himself on using the best techniques available in order to offer his patients the highest quality of care and surgical expertise possible.

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Types of Incisions

Dr. Kofkoff performs breast augmentation using either the periareolar incision  (edge of the areola) or the inframammary incision (under the breast). The incisions made at the edge of the areola provides excellent access to the breast and provides Dr. Kofkoff with the ability  to develop the implant pocket with precision. In addition, by placing the incision where the pigmented areolar skin meets the surrounding breast skin, the incision can be camouflaged and usually fades quite well.

An incision placed under the breast takes advantage of the overlying breast to help hide it.  This approach is most helpful when there is sufficient breast size to settle over the incision.  The inframammary incision also permits an incision of the appropriate length in woman whom have small areolae. 

Types of Placement

Breast implants are inserted into a space, or pocket, that is developed at the time of surgery.  This pocket can be located beneath the breast tissue and above the chest wall muscle (subglandular location) or beneath the breast tissue and muscle (submuscular  location).

Placement of the implant behind the breast tissue and above the chest wall muscle positions the implant adjacent to the breast tissue itself.  Some physicians believe this gives a more natural appearance.  By avoiding manipulation of the muscle, the postoperative recovery is easier and there is less movement of the implant when the muscle contracts.

More commonly, Dr. Kofkoff prefers to position the implant behind the chest wall muscle.  Subpectoral placement allows mammograms to be obtained more easily and may also reduce the incidence of capsular contracture. In addition, the muscle tends to provide a more gentle and natural slope to the upper breast, especially in women who are thin or have minimal breast tissue. The muscle also helps to hide rippling in the implant although some rippling may still be evident. Subpectoral placement may be “partial” or “complete” depending on how much of the muscle is released.

Types of Implants

Another important decision that must be made is determining the type of implant that will be placed. Dr. Kofkoff uses both saline and silicone implants. Your individual circumstances will determine whether saline or silicone implants will best suit your needs.

In addition to deciding upon either saline or silicone implants, it is also necessary to determine if a smooth or textured surface will be used. Textured surfaces have been developed to help reduce the occurrence of capsular contracture (tight scar tissue around the implant) and, also, to help keep the implant in its proper position.

Smooth surface implants do not attach to the surrounding tissue. As a result, they may be somewhat more mobile. In addition, there may be less visible rippling than with a textured implant.

Dr. Richard L. Kofkoff and his team strive to offer the most advanced options to you, and will work closely with you to determine what will be best for you. Please contact our St. Louis, Missouri plastic surgery practice today to learn more about breast augmentation methods.