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Dr. Placik offers his patients choices regarding incisions for the insertion of breast implants. During your consultation, Dr. Placik will make a recommendation for your breast enlargement surgery based upon your physique, pre-operative breast size and shape, previous surgery, and your level of physical activity. There are four main incisions available for breast augmentation.

Board Certified Plastic Surgeon in Chicago

Dr. Otto Joseph Placik Board-Certified Plastic Surgeon

Dr. Placik is a board certified plastic surgeon in Chicago and an active member of The American Society of Plastic Surgeons. He received his medical degree from Northwestern University where he also completed residencies in general and plastic and reconstructive surgery.


Inframammary (in the fold under the breast):

An incision, one inch (for saline implants) to two inches (for silicone implants) long, is made in the fold in the shadow under the breast (the underwire location). This is by far, the most popular incision for several reasons. It has been estimated to be used in 80 percent of surgeries. Through this incision, a pocket is made either behind the breast or behind the pectoral muscle for subglandular or submuscular placement of the breast implant. The implant is inserted into the pocket. In either instance, the implant is placed under the breast rather than through the breast and is less likely to interfere with the potential for lactation and nursing. This incision is best for Silicone Breast Implants, which come from the manufacturer pre-filled and therefore require a larger incision for insertion. This incision makes for the shortest procedures and the lowest incidence of complications. There are many surgeons and scientists who believe that this results in the lowest incidence of contamination and a biofilm.

The only disadvantage of this incision is that there may be a noticeable scar under the breast. This would be especially true if there is no defined fold in the breast prior to the operation or there is no hanging of the breasts overlying the fold. In general, ninety percent of these incisions heal with excellent scars.

Breast Augmentation Incision Options
Patient Not a Model

Periareolar (around the lower border of the nipple/areola):

This incision is made at the margin of the pigmented portion of the areola and the skin of the breast. Pockets for the implant can then be made either behind the breast or behind the pectoral muscle. The implants are inserted and adjusted for symmetry. This incision produces almost universally excellent scars, meaning that healing is quick and scars are minimal. The periareolar approach allows for the placement of the implant either above or below the pectoralis muscle. This is another potential incision for use with silicone breast implants in patients with average size areola (3.5cm or more), because the incision is large enough to allow the insertion of the full implant. However, some physicians believe it may cause a higher risk of biofilm formation and subsequent capsular contraction. It tends to be preferred in individuals who are at higher risk for hypertrophic or keloid scar tendencies.

Axillary (armpit):

The axillary incision is made through a crease in the armpit. Occasionally, it requires the insertion of an endoscope, a long tube with a camera that allows Dr. Placik to perform the procedure with a very small incision when using saline implants. The pocket for the breast implant can be made in front or behind the pectoral muscle. The advantage of this approach is that there are no scars on the breasts. This approach tends to be slightly more uncomfortable in the immediate post-operative period, and this approach is difficult to perform for silicone breast implants. A bad or hairless scar may be visible in bathing suits or tank tops.

Umbilical(belly button):

This is also known as the TUBA or Trans-Umbilical-Breast-Augmentation approach. A small incision is made in the belly button and a tunnel is made from the incision to behind each breast. The deflated saline implants are rolled up like cigars and passed up these tunnels. They are inflated, checked for symmetry, and the incision is closed. As with axillary incision, this approach has the advantage of not putting scars on the breast. The tiny umbilical scar is practically unnoticeable.  Studies have shown that this procedure has a high level of satisfaction. Although there was an initial burst of enthusiasm for this procedure, it has subsided. Dr. Placik has stopped recommending this approach; He has corrected numerous TUBA procedures and has since abandoned the surgery.

If you are interested in learning more about the variations of breast enlargement surgery, contact us online for your initial consultation.


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Practice Policy Update Regarding COVID-19 View Update Virtual Consultation


Coronavirus (Covid-19) Update

Updated March 24th, 2020

With businesses all around us closing by either mandate or voluntarily you may be wondering how long we will continue to operate, or even why we are still open at this point.

After serious consideration and in line with the recommendations of our State and Centers for Disease Control (CDC), we are limiting the practice until April 7th.

We are diligently monitoring conditions and recommendations from professional organizations such as the Center for Disease Control (CDC) and understand that the situation is ever-changing and may alter our plans at any point in the future

As physicians, we are cognizant of protecting our own patient population most at risk and the need to conserve our own limited resources. Actions have already been taken to postpone or cancel appointments and surgeries for patients who are best served staying home to limit potential exposure. We have also canceled or rescheduled appointments for services that are not immediately necessary in many cases.

Effective immediately the following will occur:

  • All procedures and in-person consultations will be limited until April 7th. This may be revised in the following week.
  • The office will be (not fully) staffed, and we will see our urgent post-surgical follow-ups.
  • We are instituting Virtual Consultations for all potential patients.
  • Many surgeries are rescheduled and some of the ones that are committed will occur on a per case basis.
  • No patient will ever have any financial recourse for our fees for rescheduling their procedures.

We are constantly updating our services and staffing according to the local and national recommendations and will always place your health and well-being as our top priority.

We continue to exercise all the latest recommendations that are handed down by the CDC. These include:

Staff have been fully informed and trained to understand the disease process and its modes of transmission.

  • All staff, vendors and ancillary personnel are being asked to refrain from coming to this office if they have any signs or symptoms of a cold or an upper respiratory tract infection.
  • Every patient is also being asked to refrain from coming to the office if they have any symptoms.
  • We are asking our patients about any pertinent travel history.
  • Hand-washing continues to be the most important mode of prevention. Although it is a part of what we constantly do, now we are doing so with heightened vigilance and attention.
  • We have instituted a “no handshakes no hug” policy for now.
  • We have asked all vendors that any unnecessary meetings are canceled until further notice.
  • Any exit and entrance from our office are followed by a protocol of changing shoes, scrubs and sanitization.
  • As we are an (NO accredited) medical facility, we are constantly sanitizing all surfaces. We have now vamped that up and our routine, multiple times a day, wiping down all surfaces, desks, door handles, keyboards and restroom facilities. (We have assigned a person that does so on a constant basis.)

As previous communications have shared, procedures and protocols have been put in place (and continue to evolve) to protect our employees in the workplace. However, no one can guarantee the absolute protection from infection or potential exposure despite recommended precautions being taken.

The virus can be transmitted before an infected person starts exhibiting symptoms. It is possible for a person to be infected and also not experience symptoms. We are doing everything possible to prevent people exposed or exhibiting symptoms from access to our facilities. Even with all of our precautions, exposure to patients with the COVID-19 virus can happen. When we become aware of any potential exposure, our response is immediate and actions are taken to protect everyone directly involved.

Experts are predicting that 40% of the Chicagoland population will be infected within the next month. Current information demonstrates that for 97% of the people infected the symptoms will be mild or flu-like. 3-5% of patients will require hospital care, and the mortality rate is less than 2%.

Risk of exposure will occur at every touchpoint of our daily lives outside of our home-- including gas stations, grocery stores, and medical facilities.

Although Covid-19 is a serious issue, we strongly believe that it will pass and hopefully make our infrastructure and our ability to deal with pandemics in this Country even better than it currently is. We are monitoring this situation on a real-time basis and will not sit back until we know that we have done everything possible to avoid unnecessary exposure.

Here are some links that might be useful:

Please do not hesitate to contact us. We are always here to answer your questions

Please allow us time to respond.

Call us at our current phone line to leave a non-urgent message or via our online email, contact form, virtual consultation or apex chat service popup box. As always for any emergency services, please call 911