breast tissue - cut at aerola vs incision in the axilla

[saggyboobs]

Some surgeons rather than cutting the edge of Aerola to remove the breast tissue have been removing tissue through a 1 cm incision in the axilla.

I always wondered if this was effective. But after seeing the pic's of the tissue that was removed 's  through this technique I was surprised.

Would like to know the good's and bad's of this technique.

[Dr. Elliot Jacobs]

I perform most of my procedures in a stepwise manner, in which a small incision near the armpit is used first.  I use sharp instruments of my own design and oftentimes I can get a nice result without having to cut around the areola.

However, many times there is very solid breast tissue just beneath the areola which cannot be removed except for a direct peri-areolar incision, which will allow for very precise removal of any remaining solid tissue.

The resultant peri-aeolar scar heals extremely well in the vast majority of cases.

Dr Jacobs

[DrPensler]

To be blunt, incisions only in the axilla fail to adequately remove glandular tissue. Glandular tissue cannot be adequately removed via liposuction alone.

[saggyboobs]

Dr. Pensler and Dr Jacobs

www.gynecomastia.org/smf/20/surgery-with-levick-booked-for-3102013-i%27m-terrified-and-have-questions/15/

In the above link on page 2 if you see the amount of breast tissue that was pulled out through incision in axilla is amazing. Its a different technique Dr Levick used its not mere Lipo .

[Dr. Elliot Jacobs]

I am familiar with this technique.  In fact I have the instruments and have done a few cases this way.  Actually, I started some cases this way.  Most of the time I gave up, did my regular lipo and then proceeded to perform a peri-areolar excision for the remaining tissue.

There are many ways to get a good result.  Dr Levick obviously feels most comfortable with his approach; Dr. Pensler and I (and I suspect many other surgeons) feel most comfortable doing it a different way.  What counts, though, is the final result.

If you are dead set about avoiding a peri-areolar scar, then consult with Dr Levick.  But I would not try to push a surgeon, who is capable of securing a good result for you with his own technique, into a situation where he is out of his comfort zone and not apt to provide you with the results you desire.

Your choice.

Dr Jacobs

[Litlriki]

I also prefer the peri-areolar incision to remove the sub-areolar glandular tissue, and I find it is much more precise in my hands.  As Dr. Jacobs has said, you should allow the surgeon to determine the best approach in his or her hands. If you want a specific approach, find the surgeon who regularly uses that approach effectively. 

Rick Silverman