Today, I am going to discuss and you are going to see me performing a periareolar breast augmentation. Periareolar means around the areola. So, let’s start the surgery. When I perform the surgery, I make a cut in the lower part of the areola. I then dissect vertically down through the breast tissue, cauterizing any bleeders, until I identify the landmark of the pectoralis major muscle. In this diagram, you will see the dissection until we reach the muscle of the chest. The pectoralis major muscle lies under the breast. Once I identify the pectoralis major muscle, I dissect over the muscle inferiorly and detach the muscle on the lower part from the midline all the way to the side of the breast. I will then insert either a saline implant or a silicone implant. If it is a saline implant, I will place the saline bag through the incision and inflate the breast to make it bigger. If it is a silicone implant,I will insert the implant using a funnel or some other device to recreate the beautiful breast. The incisions are closed in multiple layers by putting deep sutures into the breast,followed by deep dermal sutures, followed by a running suture. You will be going home the same day.
As a reminder, when I perform a periareolar breast augmentation, there tends to be a little bit more bruising and swelling than with the inframammary approach for breast augmentation. The reason is because, to perform a breast augmentation through the areola, I have to dissect more extensively in order to reach the pectoralis major muscle and the plane above the muscle or below the muscle.