The type of approach for breast surgery will depend on various factors, such as the size and material of the prosthesis, the chosen insertion plane, and the patient’s expectations or health status.
When performing breast surgery, for example, a breast augmentation with a prosthesis, the approach can be done in different ways: through the periareolar route, that is, through the areola; axillary or through the submammary groove. The choice of one or another type of approach for breast surgery will depend on various factors, such as the size and material of the prosthesis, the chosen insertion plane and the expectations of the patient or her state of health. But, what are the compelling reasons that make surgeons choose a type of approach to breast surgery?
Whenever possible, they usually make the decision to perform the mammary approach through the submammary groove since it allows entering the posterior part of the breast, respecting the glandular anatomy to a great extent, without crossing it. There they already choose, depending on the needs of the case, whether to place the prosthesis in front of or behind the pectoral muscle.
When performing an inferior perioareolar approach, at some point, either horizontally or downwards, we will have to cross the mammary parenchyma, slightly increasing the risk of any subsequent complication appearing. In addition, this approach, despite the fact that current techniques allow insertion of the prosthesis with a minimal incision, leaves a more visible scar, as it is around the areola. On the other hand, the scar in the case of the approach through the submammary groove, is perfectly concealed when one is in a natural position, with the arms down.
Advantages of the approach through the submammary arch:1.-Glandular tissue is not altered.2.-Lower risk of contamination of the prosthesis.3.-Decreased capsular contracture index.4.-The result of future mammograms is not altered.5.-Allows inserting larger prostheses.6.-The scar is hidden by a natural crease.
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Advantages of the periareolar approach1.- It allows to work with greater precision the asymmetries or tuberosity in the breasts.2.-The size of the areolar complex can be reduced.3.-Necessary if the submammary groove is to be corrected.4.-The incision through which the prosthesis is inserted is smaller.5.-Depending on the pigmentation of the skin, the scar can be practically invisible.