One of the most common myths about breast augmentation is that women are more likely to lose sensation if their breast implants are placed through a periareolar incision.

Sensation to the nipple areolar complex comes from the fourth thoracic nerve. The chances of disrupting or stretching this nerve is affected more from the creation of the “pocket” and the placement of the implant during surgery, than the type of incision which is used.

The more narrow a woman’s chest and the larger her breast implant size, the more likely this nerve will be stretched or injured as it travels around the chest wall and toward the center of the breast. One of the techniques we can use as surgeons is to use only gentle pressure to separate the tissues when creating the pocket at the chest border rather than using the cautery. Basically, the incision should be chosen for reasons other than loss of sensation.

Several factors that may affect the decision where the incision should be placed include size of the areola, presence of milk within the breast glands, and shape of the breast.

In the next article, Dr. Short will compare and contrast the most common incisions used for breast augmentation based on her experience of 14 years and more than 5,000 implants.