There are three commonly used incision locations for placement of breast implants: within the breast fold (inframammary crease), around the nipple (peri-areolar), or within the armpit (transaxillary). Dr. Naidu most frequently selects the periareolar incision for correction of the tuberous breast. This approach allows the surgeon to reduce the size of the nipple-areolar complex, replace the herniated breast tissue back into the breast mound, and release the constricted breast base through one incision. The infra-mammary fold can also be lowered through this incision if required. The breast implant is then placed below the muscle prior to closing the incision around the reduced areola.
The peri-areolar incision is well-concealed and tends to heal very well. For tuberous breast surgery patients, the incision is typically located around the entire areola, and often this is the only incision which is required. In some cases of the tuberous breast deformity, there is excess skin. In these cases in which a breast lift is also required, a vertical incision may be added which allows the breast to be lifted while excess skin is excised. This incision is also known as a “lollipop” incision, as the scars will be around the nipple-areolar complex and down the lower pole of the breast.
Dr. Naidu uses the Keller Funnel™ for the insertion of silicone implants in every case. The Keller Funnel™ is an implant delivery device which allows the surgeon to place a silicone implant easily through a small incision, while reducing the amount of contact between the surgeon’s hands and the implant. The Funnel™ has an interior hydrophilic coating which creates a slick surface and a low friction interface. The implant gently passes through the Funnel and into the breast pocket, limiting trauma to both the patient’s tissues and the implant.