Once a woman has decided to have breast augmentation surgery, her consultation with Dr. Khalifeh of Chevy Chase, Maryland, will enable her to decide on the type of surgery she prefers. She will need to make many choices, beginning with choosing the type of implant: saline implant, silicone implant or fat transfer.  Upon opting for a silicone implant, one must then decide on which type, cohesive gel or traditional? What shape: round or anatomical?  Should the implant be smooth or textured? Where should the incision be located, the breast, the armpit or the navel? There are many decisions to be made and trusting in the expertise of Dr. Kahlifeh will help you make the decisions that will make you the happiest with your surgery.

One of Dr. Khalifeh's favorite incisions is the periareolar incision around the nipple.  This incision is popular among cosmetic surgeons in Brazil, Mediterranean Europe, and other "beach- friendly” places because it is almost invisible once healed. The periareolar incision is made on the edge of the areola, the pigmented skin surrounding the nipple. Silicone implants are prefilled and cannot be rolled up the way empty, saline implants can. The size of the nipple, and thus the maximum size of the incision allowed, determine the maximum size of the implant. For smaller areolas, the limit is an implant that is 275 cc. The cubic centimeter or cc is the unit of measurement for the sizing of the implants. For medium-sized areolas the limit is 350 cc.  Saline implants are not under this size limitation because they are rolled up and inserted when empty. The implant is not filled with the saline solution until it is in place.

Once the periareolar incision is made, the implant may be placed under the breast tissue but on top of the pectoral or chest muscle, partially under the chest muscle, or completely under the chest muscle.  Working in this area is easier for a surgeon because the incision is so close to where the implant will be placed and this affords the greatest control and the greatest degree of precision.  If any problems arise later, this same incision site may be reentered.  Disadvantages include the rare occurrence of the loss of sensation to the nipple. The periareolar incision is associated with potential problems with breastfeeding because milk ducts may be disrupted, although this is very rare because most of the surgery is done in a direction leading away from the ducts. Normal bacteria are found in the milk ducts and infections may occur that are caused by the implant coming into contact with these bacteria. This can easily be prevented with the use of a protective sleeve to insert the implant so that it does not come into contact with surrounding tissue. The periareolar incision may inhibit cancer detection.

Call to schedule a consultation with Dr. Khalifeh at (301) 244-0148.