Breast augmentation is the most commonly performed aesthetic operation in the Unites States annually. With the increasing popularity of gel implants, optimal incisional length for specific implant volumes becomes a factor to consider. Our study is the first, to date, to measure optimal incisional length for increasing Mentor smooth, round, moderate plus silicone implant volumes. Three cadaver breasts were dissected in our anatomy laboratory. After dissection of a subpectoral pocket via an inframammary fold incision, time of implant insertion was measured for increasing volumes with the use of increasing incisional site lengths. Values for increased incisions are as follows: 2.5-cm incision facilitated 100-cm implant (average time [AvgT] 76 seconds); 3-cm incision 100-cm implant (AvgT 32 seconds), 200 cm (AvgT 84.33 seconds); 3.5-cm incision 100-cm implant (AvgT 13.00 seconds), 200 cm (AvgT 22.00 seconds), 300 cm (AvgT 33.67 seconds); 4-cm incision 100-cm implant (AvgT 5.67 seconds), 200 cm (AvgT 11.33 seconds), 300 cm (AvgT 21.33 seconds), 400 cm (AvgT 26 seconds); 4.5-cm incision 100-cm implant (AvgT 5 seconds), 200 cm (AvgT 15.17 seconds), 300 cm (AvgT 19.67 seconds), 400 cm (AvgT 26 seconds), 500 cm (AvgT 39.67 seconds), 600 cm (AvgT 59.33 seconds), 700 cm (AvgT 78.67 seconds); 5-cm incision 100-cm implant (AvgT 1 second), 200 cm (AvgT 3.67 seconds), 300 cm (AvgT 8 seconds), 400 cm (AvgT 13 seconds), 500 cm (AvgT 19.33 seconds), 600 cm (AvgT 23.33 seconds), 700 cm (AvgT 28 seconds), 800 cm (AvgT 33 seconds). Based on our results, the optimal incision size for increasing Mentor smooth, round, moderate plus volumes is as follows: 2.5 cm for 100-cm implant, 3 cm for 200-cm implant, 3.5 cm for 300-cm implant, 4 cm for 400-cm implant, 4.5 cm for 500- to 700-cm implant, and 5 cm for 800-cm implant. This guideline can be used to provide the most aesthetic results without tissue compromise.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6432996PMC

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