Dr Rude:
"There are three common incisions for breast augmentation;
the armpit, the areola, and the crease. Generally all the scars are very good.
There is not one particular approach that has clearly superior scars. The vast
majority of the time the scars from all three approaches are very nice. There
are several pros and cons to the different approaches. While an armpit or
transaxillary can be done very well it generally has a higher revision rate
than through the crease. The areola approach has the disadvantage of having a
higher change of changes in nipple sensation. However, the most significant
problem with these two approaches is their incidence of capsular contracture.
Capsular contracture is where the scar around the implant gets hard. One of the
causes of capsular contracture has been discovered to be bacteria trapped
within the scar around the implant. This is most likely a manifestation of a
biofilm. The areola and the armpit have vastly higher rates of capsular
contracture compared to the crease. Some studies have shown a five times higher
rate through the nipple and a thirteen times higher rate through the armpit.
Capsular contracture can be a very serious complication of breast augmentation.
For this reason I choose to do my breast augmentations through the inframammary
crease."
