Breast Augmentation – Which Incision is Best

In life it is always good to have choices and such is the case for breast augmentation.  My preferred site is to use the inframammary approach.  Sometimes I will utilize another incision if the operation is an implant exchange and the patient already has the incision.  I never use the belly button and shy away from a peri-areolar incision.  My main reason for NOT using a peri-areolar incision is due to the fact that the nipple is the “dirtiest” part of the breast as it has a high bacterial count.  Well I just read a study where some plastic surgeons did some cultures of the breast skin and ductal tissue.  They found that during a peri-areolar breast aug you had a HIGHER degree of contamination by using this approach.  Many people feel, and I also believe that the introduction of bacteria can lead to the formation of a “biofilm” which can cause marked encapsulation.  This is one reason I give my patients intravenous antibiotics just before operating.


Dr. Brueck

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