With more breast enhancement operations being conducted today than ever it is vital that people understand what is involved. This brief article looks at the incisions used to place the breast implants inside the body, and also the positioning of the implant in its final location within the breast.
Types of incision
Implants for breast augmentation are able to be positioned into each breast through a variety of methods:
An incision is created along the circumference of the areola. An incision such as this provides the best approach for mastopexy (breast lift) operations or IMF (infra-mammary fold) adjustments. The incision stretches along the inferior half/ medial half of the areola's edge. Using this method of insertion larger breast implants are difficult to implant.
A surgical cut is made beneath the breast on the IMF. This method of implant insertion is most common since it allows a large access point for dissection and subsequent placement of implants. Inframmary incision enables wider incisions which therefore make it the most popular incision choice for those people opting for silicon breast implants.
Not so common, this technique involves creating an insertion around the navel with dissection that tunnels up towards the breasts. Implants can be moved through these cuts all the way up and into the breasts without any visible incisions near the breasts. Appropriate dissection and positioning of the implants is more difficult than with the other incision procedures. Endoscopes (very small camera with a light) are sometimes used in this operation to allow dissection, otherwise the normal procedure may be performed bluntly. Blunt insertion of implants dictates that silicon filled varieties are not used due to their possibility of rupturing.
A surgical cut is made at the armpit nearest the breast to be filled with an implant. Tunneling then occurs medially so that no visible scars on the breast are created. Endoscopes are sometimes used.
Much like the TUBA method, this procedure involves someone who is already requiring an abdominoplasty (tummy tuck) to also have two separate tunnels created to each breast, from the abdominal incision. Each breast implant is pushed through each tunnel and into bluntly dissected pockets in the breasts.
Implant pocket placement
Implant placement is made with reference to the pectoralis major muscle.
The implant is placed between the pectoralis muscle and the breast tissue. Regarded by many people as producing the most aesthetic results, the position of the implant closely mimics the natural plane of the breast tissue. People with thin soft-tissue coverage are more likely to display wrinkles or ripples from the implant beneath. Capsular contracture is also more common with this technique.
Also termed 'dual plane' placement, implants are positioned beneath the pectoralis major muscle after dislodging the pectoralis muscle attachments. The implant lies partly under the pectoralis in the upper pole, the lower half of the implant residing in the subglandular plane. Most commonly used in North America, this technique allows the maximum upper implant coverage whilst at the same time enabling the expansion of the lower pole. Capsular contracture is less likely with this procedure.
Positioned in a subglandular position, the implant sits under the pectoralis muscle fascia. Benefits to using this method are debatable, it is claimed that the thin vascularized fascia can aid coverage and keep the implant in its position more effectively than with other placement methods.
Placed beneath the pectoralis but without the inferior origin of the muscle being released, the implant is well covered by muscle. Complete coverage of the implants by muscle can be achieved through releasing the chest wall muscles (seratus and/ or pectoralis minor) and sewing them to the pectoralis major.
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