Breast Augmentation Las Vegas

Which Incision Placement is right for me?

The placement of your incision will determine the scar that results after your surgery. Dr. Costa always uses the best techniques to make your incision and scarring as little as possible. Most people who seek out Dr. Costa to perform their breast augmentation do so because he is one of the best at transaxillary endoscopic breast augmentation. This approach places a small incision in the armpit crease, which means there is NO SCAR on the breast. Most patients are good candidates for this approach; however, Dr. Costa may recommend a different approach if it will be better for your anatomy.

• Transaxillary – Dr. Costa offers transaxillary breast augmentation for patients who are candidates and are interested in surgery without putting a scar on the breast. This procedure is less invasive and involves an endoscopic camera that is inserted through a small incision in the underarm. The advantages of this technique are that the implant can be placed without any scar on the breast. It also leaves the breast tissue untouched without any damage to the glands. Dr. Costa can use silicone or saline implants when performing a transaxillary approach. The potential risks associated with this approach are a reported higher risk of changes to the sensation of the breast, implant malposition, and capsular contracture. It is important to go to a surgeon who regularly performs this type of procedure if you desire a transaxillary endoscopic breast augmentation to maximize your aesthetic outcome.
• Inframammary Fold – A 3-4cm incision is placed in the fold under the breast that, when healed, is very difficult to detect. This approach cuts through a very minimal amount of native breast glandular tissue. This results in the lowest rates of capsular contracture and malposition. It is no surprise that this is the most commonly used incision by plastic surgeons as it offers a safe approach to placing the implant and is well hidden.
• Periareolar – This is an incision placed around the areola of the nipple. The advantage of this approach is that in some patients this incision is very hard to see because it may scar the same color as the pigment. The disadvantage of this incision is that you must cut through all of the native breast glands to get to the area where the breast implant is to be inserted. When you insert an implant, it rubs against all of those cut breast glands which are not sterile and have the possibility of introducing bacteria to the implant. This can result in an increased risk for capsular contracture, or even worse, an infection. Additionally, this approach will cause damage to the breast tissue and result in some atrophy of the native breast around the incision, which increases the risk for contour deformities around the incision site.
• Transumbilical (TUBA) – This approach places an incision at the belly button, and then a tunnel is created under the skin to deliver an implant to the breast. The advantage of this approach is no scar is present on the breast. However, to use this approach, only a deflated saline implant can be inserted, not silicone. The procedure also creates a tunnel through the native inframammary fold and weakens the supporting tissue under the implant. This results in much higher rates of malposition and the need for revision.

Dr. Costa’s Preferred Approach – Dr. Costa prefers to use a transaxillary approach for patients who desire not to have an incision or scar on the breast. He has dedicated himself to learning the subtle technical aspects of this technique and likes to offer it to patients who are appropriate candidates. Dr. Costa also commonly uses an inframammary fold approach since it gives the lowest rates of capsular contracture and the lowest rate of complications to the patient. When performed correctly, this incision heals extremely well and is very difficult to see, even on patients with darker pigment.