Pathways and position of the prosthesis
There are three pathways: the hemiareolar inferior border, under breast and axillary. The choice of path is based on the diameter of the areolas, the volume of prostheses and habits of the surgeon. The axillary way deemed to be the most discreet uses endoscopy and has the disadvantage of bad bleeding control. The areolar path is very satisfactory but may sometimes become visible because of residual scar depigmentation. The subcutaneous breast offer discretion and safety of the procedure when well placed just in the future furrow.
The choice to place the implant behind the gland or behind the chest muscle is based on the volume of existing gland. When it’s sufficient to hide the circumferences of the prosthesis we will just place it behind gland. If instead the breast is too small, it is preferable to insert under the muscle. Muscle back position is more painful and requires the patient not to raise arms for a month at the risk of dislocating the prosthesis to the armpits. Moreover, with time, the fall of the glands is not accompanied by the prostheses and creates an imbalance; the prostheses remain suspended. The glandular retro position does not present these disadvantages. The size of the prosthesis must be adapted to the chest and volume of existing gland of the patient.