Capsular contracture is one of the most feared complications of breast augmentation. If you suffer severe capsular contracture, your breasts will grow hard, deformed, and painful. The only remedy is revision surgery. Obviously, both you and Dr. David Bottger want to minimize your risk of capsular contracture. Can we do this by selecting one breast augmentation incision over another? Nobody knows for sure what causes capsular contracture, but one of the popular current theories is that capsular contracture can be caused by exposure of the implant to bacteria. When the periareolar incision is used to insert the breast implant, it is more likely that the implant will come in contact with bacteria from the ducts that run to the nipple, and therefore it might make sense that the periareolar incision might increase your risk for capsular contracture. There is one study that links the periareolar incision with capsular contracture risk, finding that the periareolar incision was linked to an almost 10% risk of capsular contracture, as opposed to only a 0.59% risk for inframammary incision. But the study has a number of problems. Most importantly, the study focuses only on a review of one surgeon’s work. Since many other studies point to the role of a surgeon’s technique as a key component of capsular contracture risk, it’s possible that the study only tells us that breast augmentation using the periareolar incision increases your risk for capsular contracture WITH THAT SURGEON. A number of charges have been leveled at the periareolar incision, such as that it increases the risk of loss of nipple sensation and that it makes it more likely you will be unable to breastfeed. Each of these charges are supported by one study, but not by others. During your consultation, Dr. Bottger will talk to you about this important choice and let you know his personal experience with the periareolar, inframammary, and other incisions so that you can make a fully informed decision. To schedule a consultation, please contact David A Bottger, M.D. today.