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Comparison of Breast Augmentation Incisions and Common Complications

Aesthetic Plastic Surgery volume 36, pages 1096–1104 (2012)Cite this article

Abstract

Background

Incisions for insertion of breast implants are most commonly placed in the inframammary fold, areola, or axilla. Previous studies have evaluated selection of incision location preoperatively and for nipple–areola complex sensation retention after primary augmentation mammaplasty. This study compares the most common postoperative complications for each incision location in patients who underwent primary breast augmentation.

Methods

A retrospective chart review was performed on 619 patients who underwent primary breast augmentation, excluding simultaneous mastopexy, within a single group practice from July 1994 to June 2009. Incision location, postoperative complications (capsular contracture, hematoma formation, rippling, infection, and rupture), and total reoperation rates were recorded. Incision locations were also compared with respect to implant fill type (saline or silicone gel) and pocket location (subglandular or submuscular).

Results

A statistically significant association was identified between total reoperation and incision location (p = 0.0054). The highest rate of total reoperation occurred when using an inframammary fold incision compared to either the transaxillary or periareolar. This relationship with total reoperation was not attributed to the five complications analyzed, but rather with patient desire for size/style change, asymmetry, or ptosis. No statistically significant association was observed between incision location and specific complications such as capsular contracture, rippling, implant rupture, hematoma, or infection.

Conclusions

None of the five complications analyzed correlated with incision location. The data generated from this study will assure the surgeon that all three incision locations are safe. Preoperative examination, patient preference, and surgeon comfort should remain the mainstays of incision planning in augmentation mammaplasty.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors at www.springer.com/00266.

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Acknowledgments

The authors thank Dr. T. Roderick Hester, Dr. Foad Nahai, Dr. Farzad Nahai, and Paces Plastic Surgery for allowing the use of patient data in this study.

Conflict of Interest

M. A. Codner has served as a consultant to Mentor Worldwide LLC. He has also received educational grants from Mentor and receives royalties for books published by Quality Medical Publishing and Elsevier Publishing Company. R. L. Stutman, A. Mahoney, and A. Amei have no conflicts of interest to disclose.

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Authors and Affiliations

  1. Mark Codner, M.D. Plastic Surgery, 1800 Howell Mill Road. Suite 140, Atlanta, GA, 30318, USA

    Ross L. Stutman, Mark Codner & Amy Mahoney

  2. Department of Mathematical Sciences, University of Nevada Las Vegas, Box 4542020, 4505 Maryland Parkway, Las Vegas, NV, 89154, USA

    Amei Amei

Authors
  1. Ross L. Stutman
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  2. Mark Codner
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Correspondence to Ross L. Stutman.

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Stutman, R.L., Codner, M., Mahoney, A. et al. Comparison of Breast Augmentation Incisions and Common Complications. Aesth Plast Surg 36, 1096–1104 (2012). https://doi.org/10.1007/s00266-012-9918-x

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Keywords

  • Breast augmentation
  • Breast augmentation incision
  • Breast augmentation complications
  • Capsular contracture