Areola The most common breast implant method of insert is through a small 2 to 3 cm incision at the areola border. The transition in skin color between regular breast skin and the darker areola skin color is the perfect place to hide a small scar. Under the breast Another common site to insert breast implants is the fold under the breasts. As the breasts enlarge, the breast tissue will typically fold over at the bottom, thereby covering any visible scars in the standing position. When a patient lies down the scars may be visible. Underarm Using modern endoscopic equipment, which involves pencil thin lenses and camera systems, a doctor can place implants through an incision under the arms, which hides the scar in the natural folds of the underarm creases. The advantage of the underarm approach is the absence of any scars on the breasts. Since it is currently not easy to revise or re-operate on the breast through the same underarm incision, the disadvantage to this approach is the need for another incision site and scar on the breast, should another surgery be necessary in the future. Breast Implant Breast implants alter the size and shape of the breasts. There are two primary types of breast implants: saline-filled and silicone gel-filled implants. Saline implants have a silicone elastomer shell filled with sterile saline liquid. Silicone gel implants have a silicone shell filled with a viscous silicone gel. Breast augmentation surgery involves using breast implants to achieve fuller breasts. Some women have breast augmentation surgery to improve their self-image. Some feel dissatisfied because the size of their breasts do not meet expectations. Others want to bring balance to a breast that is somewhat smaller than the other is. Often women want the procedure to restore their natural breast volume, which may have decreased because of pregnancy, weight loss, aging or even breast cancer surgery. A surgeon performs the procedure in a surgical facility under a light where an anesthesiologist administers a general and local anesthetic for the surgery, which lasts from one to two hours. The surgeon enlarges the breasts by placing soft implants through a small incision, either though the armpit, from around the nipple or under the breast. Both saline and silicone implants are now available. Endoscopic Endoscopic is the most modern technique for breast enlargement surgery. A surgeon makes a small incision in the axilla (underarm) and uses an endoscope to introduce the implant, either under the pectoralis muscle or the breast tissue. The doctor employs absorbable sutures throughout the procedure to assure the comfort of the patient. The unique features of this technique are the small incisions used to perform the procedure and the location of the incisions in the axilla or armpit. Therefore, no scars are visible on the breast or at the breast crease, which lead to excellent aesthetic results. It is an ideal procedure for those patients with smaller breasts where the scars on the breast would be visible, and for those who have a predisposition to abnormal scarring. Axillary Doctors use an axillary approach when the breasts of the patient are small, in good position and are relatively symmetrical. Cosmetic surgeons introduce the implant through a 1- to 1 1/2-inch incision in the center of the axilla and generally place the implant under the muscle mass. In patients who are extremely muscular, this placement may show movement of the implant; in such cases, the doctor puts the implant over the muscle tissue. To finish the procedure the doctor uses absorbable stitches at underarm area and uses a small tubular drain to collect fluid for a day or two in order to decrease swelling. Nipple This commonly used approach involves a 1- to 1 1/2-inch incision on the lower border of the pigmented areola and allows some correction of shape and position discrepancies of the breasts. The incision generally heals well with minimal scarring. Although blockage of nipple ducts is a theoretical problem, it rarely occurs. Most women are able to breast feed after this procedure. Inframammary Incision In a small number of cases where the areola is very small, the doctor makes an incision at the crease below the breast. This approach may be suitable with the most complicated breast augmentations or for women who had previous breast surgery.

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