Lower hemi periareolar incision is the state of the art and best approach to perform breast augmentation and implants insertion, either from a technical point of view regarding safety, the medical side for the patient's future options and the aesthetic outcomes.
Its main advantages are its superior scar aesthetic quality thanks to the thin areolar skin, it can be repeated unlimited number of times, allows renewal of ruptured implants and silicone remains complete cleansing, prevents additional scars in the future due to renewal of implants, should the size of the implants be changed the submammary crease modification does not affect scar location, it is hidden in underwear and swimming wear, an areolar tattoo by micropigmentation may virtually delete it, allows an accurate and meticulous surgical work with full visualization of the entire prosthetic pocket thus associating the procedure with the lowest rate of complications like hematoma, sensation loss, etc, allows additional maneuvers of essential kind in revision mammoplasties like capsulectomy, capsulorrhaphy, etc, and many others making this incision the first choice of indication for breast implants surgery of any kind and a mandatory one in revision mammoplasties.
As only disadvantage it might be unfeasible in very small areolas cases and it is slightly more laborious for the surgeon.
Pregnancy, breast feeding, mammograms, ultrasound, breast examination and biopsies are perfectly compatible with this technique and equally efficient.
In some cases the hemi periareolar access to the breast is associated to a circumferential resection of a skin donut in order to downsize or flatten the areola and eventually to make this approach feasible in areolas of borderline size.
This incision can be also used in the breast removal in males with gynecomastia.