Breast Implant Incision Types

Breast Implant Incision Types

Another thing to consider with your breast augmentation surgery is the incision site. Dr. Smith prefers to place the implants through three of four areas on your body. The incision usually are about 1-2 inches long, allowing him the ability to place your desired implants. They can be placed thru your armpit, through the colored part of the areola (periareolar incision) or in the crease underneath the breast, called the inframammary incision. The fourth one is called the transumbilical incision, which is the method of placing the implant through the belly button incision, then filling it with fluid. Dr. Smith almost never does this procedure because most implants women choose are silicone gel. It’s a much nicer, softer implant that allows you more options for your breast augmentation, however it cannot be placed through the belly button incision. Dr. Smith will further explain the advantages and disadvantages during your consultation. Many surgeons can only place the implants through one incision, so by choosing Dr. Smith you’ve allowed yourself the flexibility of choosing the incision that best suits your goals. He’s highly skilled in breast augmentation and is able to place the implant through any of the three incision site choices.

the periareolar and inframammary incisions are only seen when you are topless

Periareolar Incision

The periareolar incision is an incision that is made in the colored part of the areolar, underneath the nipple. The advantage of this incision is that the scar hides very well. If you have dark pigmented skin, there’s a chance you may form a dark scar. The dark scars hide in the dark areola very well and can be completely invisible. Another advantage of this incision is that sometimes we can get a little more lift if you have very droopy breasts. The main disadvantage of this incision is the slightly higher chance of changing nipple feeling. Whenever we place a breast implant, there is a chance that nipple feeling can change through any of the three incisions. However, when we go through the periareolar incision, the risk is slightly higher. Also, if you have a very small areola, it may not be possible to place large breast implants through the small areola.

Inframammary Incision

The inframmary incision is the incision that is in the crease underneath the breast. You may choose this incision because it hides very well. The advantage of this incision is that when you’re upright, the incision is not seen because your breast will cover over the incision.You’ll typically recover the quickest of any of the three incisions, and have a lower chance of changing nipple feeling than the periareolar incision. Your main disadvantage of this incision is that the scar can sometimes be seen when you lay flat on your back, lifting your breast.

Transaxillary Incision

If you’re looking to avoid having any scars on your breasts, the armpit incision has that advantage. However, there are several disadvantages to this incision. The main disadvantage is that this incision has the most painful recover and you’ll usually need about twice as long before you can return to work. The other disadvantage is that is more of a public incision, meaning the armpit incision is a little more noticeable in public. It can be seen in regular bathing suit, tank top or strapless dress, when you lift your arm and expose your armpit. However, the incision is in your armpit and may feel that people don’t really look at your armpits. Another disadvantage is that there is a small risk of losing feeling in the armpit area, which does not exist with the other incision sites. If you’re really concerned about the incision not being on your breasts, then you should choose the transaxillary (armpit) incision.

The advantages, and disadvantage, of each incision will be discussed by Dr. Smith during your consultation. Most incisions get a little darker, for about six months, then narrow and fade for about two to three years. If you take good care of your incisions, utilizing special scar gel, scar tape, and assorted scar lasers that we have at our medical spa, most incisions will become invisible. And the choice of the incision is less important than you think

If you have any more questions about breast implant incision types, please call 702.838.3755 so we can answer your questions, or schedule your consultation. You can also fill out the form to the right and one of our Patient Coordinators will call you as soon as possible..

Size of Breast Implant

Size of Breast Implant

Choosing the size of the implant is one of the most important things that you will do at your breast augmentation consultation. Some surgeons actually choose the size of your implant, however everybody has different tastes, like and dislikes. At Smith Plastic Surgery, we allow you to choose the size of your breast implants. As mentioned before, we feel this is one of the most important choices you can make.

During your consultation, our staff will place you in a special sizing bra. They will then give you many options with different sized implants, and you will be able to look in the mirror to see the different sizes. When you see the size that you like, that is the size we will generally put in. Dr. Smith will also consult with you and give you some guidance regarding the implant size. However, the final decision will be yours.

To give you some better insight, the taller you are, or the broader your shoulders, the larger the implant size that you may carry — and still look natural. In other words, a very tall person can carry a much larger implant, and still look more natural than the same sized implant in a short person. If you’re shorter, the larger implants tend to look top heavy and look more exaggerated. In addition to this, the broader your shoulders and hips are, the larger the implant you can pick and still look natural. If you have narrow shoulders and hips, the breast implants may look very large on you. You can have a very natural look, and in between look, or a very exaggerated look, depending on your preferences. Dr. Smith will discuss your preferences and help guide you to the implant size, choice and position, which will give you the look you desire. Most patients today want a more natural look, however there are patients that want a more fake look. Dr. Smith feels it is a very personal decision and it is important to him that you are given the freedom to choose the size implant that you desire.

It is important to know that frequently patients chose a size that is too small. Later, once they are used to the implants, they often wish they had chosen a bigger size. It is much more common for a patient to feel she has chosen a size that is too small then that they have chosen a size that is too large. We encourage to you think carefully about the choice of your size and even to bring a “significant other,” to help you with your choice.

Responsibility for Choosing Breast Implant Size

It is Smith Plastic Surgery’s policy that we never choose the implant size. The patient always makes the final size decision. When Dr. Smith places the implants he may adjust the size of the implants 10 to 40 ccs depending on certain factors, such as one breast being smaller then the other or other factors. This amount of adjustment is approximately 1 to 2 ½  tablespoons of water distributed over the entire breast and is not a noticeable change. Therefore, if the patient is unhappy with the size of the implant after surgery, either too large or too small, they must take responsibility for choosing that size. If they wish to change to another size, we will make every effort to help them at a reduced charge. The patient will be responsible for a portion of the costs, which may run as much as four thousand dollars.

Shape of Breast Implant

Shape of Breast Implant

Although breast implants come in many shapes and sizes, basically there are two main types of shapes. One is more round, often called a “round” implant. The other is more teardrop shape and called an “anatomical or form-shaped” implant. The most common implant placed in the United States is a round implant and the most common in Europe is the teardrop shaped implant. There is a great deal of debate among surgeons as to which type of implant is best. The round implant tends to give more fullness to the upper portion of the breast and a little more cleavage. Many, if not most, patients find this desirable and choose this implant.

The “anatomical” implant gives a more teardrop shape to the breasts and may be a little more natural looking, especially in a woman who is very flat-chested, but the implant is usually more firm and can sometimes feel fake. Also, there tends to be less fullness in the upper portion of the breast that many women do not like. In Dr. Lane Smiths’ practice, you may choose either implant. When women want to have an implant changed to a different-shaped implant, most commonly women with teardrop-shaped implants ask to be changed to round implants.

If you have any more questions about the shape of breast implants, please call 702.838.3755 so we can answer your questions, or schedule your consultation. You can also fill out the form to the right and one of our Patient Coordinators will call you as soon as possible.

Over/Under Muscle Breast Implant Placement

Over/Under Muscle Breast Implant Placement

Subglandular vs Submuscular

You may have not known this, however breast implants placement can be under or on top of the muscle. Specifically, under or on top of the pectoralis major muscle. Plastic surgeons debate the benefits of both the positions, however you’ll have the ultimate decision when it comes to your surgery. Generally, most Las Vegas plastic surgeons will agree under muscle is the better implant placement. When you’re in your consultation, you’ll be asked about your concerns. Concerns like what your aesthetic goals are, your lifestyle, recovery time, etc… All of these questions will help you determine which is best for you.


When the implant is placed under the muscle this is called the submuscular position. When the implants are under the muscle, more of the patient’s natural tissue covers the implants.  This helps make the implants look and feel more natural.  Also the muscles help to hold them in alittle bit so they don’t roll out into the armpit as much and the muscles hide the rippling that can sometimes occur when the implantsare on top of the muscle. In addition to this when more of the patient covers the implant the implant tends to look and feel more natural. Dr. Smith almost always places the implants under muscle. Some of the disadvantages of placing the implant under the muscle is when you flex — for example when you’re doing push ups or pull ups, the pectorlais muscle will bounce a little bit. Or you’ll be able to see the crease of your muscle, this is also a disadvantage of placing the implant under the muscle.


When the implant is placed on top of the muscle and under only the breast tissue, this is called the subglandular position. The advantages of placing the implant on top of the muscle is that it is a quicker recovery. I’ll suggest this option to you if you have abnormally shaped breasts, so we can help round out your breasts. The disadvanatage of placing the implant on top of the muscle are many. The implants tend to have a more “stuck on” look, giving you a more pronounced size. There is a higher chance of the implants rippling and skin tends to stretch, which after a while leads to implants rolling into the armpit when you lay down. Still, you may desire to have a more exaggerated look and may consider putting the implants on top of the muscle. The advanatages of placing the implant under muscle outweight the disadvantages, so Dr. Smith usually places the implant under muscle.


Implants tend to drop, so when the implant is placed during surgery, Dr. Smith will place it slightly high. If the implant is placed under the muscle the muscle tends to push them alittle higher immediately after surgery. This means that about a week after surgery, you will think the implants are too high. Your skin and muscles need to stretch, so the implants tend to drop for 3-6 motnhs. Within that time period, your implants will be set in their new position and will usually cease to drop. It is important that you implants are not perfect right away, or they will drop too low and may look droopy.  This is actually the most common risk of breast augmentation, and runs about 5% in Dr. Smith’s practice. In the event you implants drop too low, or fail to drop enough, Dr. Smith will adjust them to help them be in the proper position.

Choosing Saline or Silicone Implants

Choosing Saline or Silicone Implants

You’ve probably calling every plastic surgeon in Las Vegas trying to find the answer to this very popular question. Fortunately, you found Dr. Lane Smith! He believes in giving you as many choices as possible. In doing so, giving you the most information will empower you to make the best decision for yourself. After many years of not allowing silicone implants for breast augmentation, the FDA finally approved silicone implants for breast augmentation. Because of this, you may now choose between Saline or silicone breast implants.

There are advantages and disadvantages to both types of implants. Silicone breast implants are filled with a silicone gel polymer.  This is a thick substance with the consistency of a very thick jello or thin gummy bear. These implants cannot really leak, but they can crack eventually. The silicone implants last longer than the saline implants, and currently have a lifetime warranty. Saline breast implants are filled with I.V. fluid (saline), which is mostly water with a little bit of sodium in it to match your body fluid.  These have a 10-year warranty, but an extended warranty can be purchased through the implant company.

Many people think the implants have to be replaced every 10 years but this is not true. The implants only have to be replaced when they rupture or crack. Both implants are expected to last much longer than 10 years. When the saline implant ruptures, it will not harm the patient, the body will simply absorb the water, but the breast will get smaller. When the silicone implant cracks, it should not be harmful either, but replacement is recommended.

The silicone implants have a softer more natural feel to them than the saline implants. They are also less prone to rippling (a slightly wavy appearance to the breast that can occur with the saline implants when leaning over). For most patients, silicone implants are a better implant and are the implants most commonly recommended by Dr. Lane Smith.

The silicone implants cost more than the saline implants. This is because all of the previous lawsuits regarding silicone implants.  Interestingly, the lawsuits were claiming the implants caused connective tissue diseases such as Lupus or arthritis. That has now been shown to be completely false, but the attorneys did not return the money to the implant companies they bankrupted, and the thousands of employees who lost their jobs from the lawsuits did not get their jobs back.  However, the price of the actual implants jumped 1000%, and this unfortunately must be passed directly on to the patient.

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