Placement of breast prosthesis via lower hemi-areolar approach

Breast augmentation by hemi-areolar approach i.e. at the level of the areola of the breast is a recent intervention technique in cosmetic breast surgery.

This type of mammoplasty leaves only a discreet scar between the white of the skin and the brown of the areola . Breast augmentation using the hemi-areolar approach is one of the three major breast surgery techniques with the scar under the armpit (axillary route) and the scar under the breast (submammary tract). When anatomy allows it, this is the preferred route.

What is the hemi-areolar pathway?

Hémi comes from the Greek meaning “half”. It is used in the composition of many scientific terms. As for areolar, it defines the aureole of the woman’s breast which surrounds the nipple. My intervention consists of creating the smallest incision possible following the contour to be able to position the implant.

Advantages of this surgical technique

As I said before, the scar is very short and practically invisible.
For smokers, this route is a good option since it allows, in the event of problems, to protect the implantthanks to the muscle and the mammary gland.
On the other hand, unlike the axillary route, the implant can be positioned to the nearest millimeter, which allows total satisfaction during the operation.
This technique will not lead to loss of breast sensitivity or an inability to breastfeed since the milk ducts will not be affected.

Disadvantages of areola surgery

If the areola is too small, it is possible to damage the implant and have a more visible scar due to insertion difficulties.
The scar is not always invisible
In some cases a loss of sensitivity of the areolas.
A breastfeeding discomfort

Example of discussion on the choice of different techniques:

On the feminine forum site you can get a good idea of the type of discussion concerning the choice of one technique rather than another, for example which is better axillary or peri-areolar route?.The options are fiercely defended

To summarize:

• Very small scar
• Implant protected by muscle and mammary gland
• Easy access implant
• Positionable to the nearest millimeter
• If the areola is too small: possible damage to the implant
• If the areola is too small: scar possibly more visible

It is possible to perform a breast implant operation in three ways:

• by axillary route (scar under the armpit),
• by hemi-areolar route (at the nipple) or
• with a inframammary passage with a scar under the breast.