A periareolar incision is a cut made by a surgeon into the skin of the breast immediately below the lower half of the areola of the nipple. This incision is most commonly used during breast augmentation procedures, breast lifts, and when removing breast implants. With this type of incision, breast implants may be placed over or under the pectoral muscle, depending on the preference of the plastic surgeon and the patient. As the periareolar incision heals, the scar usually blends into the pigment line of the areola and the skin of the breast.
After the plastic surgeon has made the periareolar incision into the breast, he will create a pocket for the placement of the breast implant. The pocket may be located under the muscle or within the glandular tissue of the breast. Then the implant is rolled into a protective sleeve, and inserted through the periareolar incision into the newly created pocket. Once the implant is secured into place, the sleeve is removed and saline can be added to the implant until the desired breast size is achieved.
Minor complications when using a periareolar incision during breast surgery are common. Some women report a loss of nipple sensitivity after this incision is used; women that have unusually small areolas may experience the greatest loss of nipple sensation following the surgery. Additionally, the milk ducts of the breast are cut when the incision is made, this may result in future difficulty breast-feeding. Normal bacteria located in the breast ducts may be released as the incision is created, causing an increased risk of a post-operative infection. Many plastic surgeons will prescribe antibiotics routinely after surgery to help prevent an infection from occurring.
If a repeat surgical procedure is needed to adjust the size of the breast implant or to remove the implant, the periareolar incision may be safely used by the plastic surgeon again. The incision scar from the first surgery usually heals as a thin flat white line; often the plastic surgeon will follow the original incision line during a later procedure to prevent additional visible scars from forming after the breast surgery. A plastic surgeon may decide that a patient who has developed a thick scar or has experienced decreased nipple sensitivity may require a different incision location for future procedures. An inframammary incision located just under the crease below the breast or a transaxillary incision through the armpit may be used instead of the periareolar incision.