Incision Decisions- Where do you want your breast augmentation scars?

Woman with her hand on her face

The majority of breast augmentations are performed because a woman desires a change in the appearance of her breasts. It is a personal decision – an elective choice. The first decision is to undergo the procedure, but several decisions will follow. What size of implant? What implant shape is best, and finally, the incision decision – where will you personally tolerate a scar best?

The diagram above lists 4 possible incision sites.   Even if you have predetermined where you believe to be the best incision is for you, there are disadvantages and advantages of each one.   Understanding each approach may solidify your choice or change your decision altogether. Consider the plus and minuses.

Implant entry incisions.

1)  Transaxillary Incision


+ An incision in the armpit is favored by some women because there will be no scar on the breast.

+ The scar often blends into the fold of the armpit and is relatively undetectable.

+ Pocket creation and implantation is a straight shot from the armpit to the breast.


– A longer scar is required for placement of silicone gel implants and this can be harder to hide in small underarms.

– Not recommended for sagging breasts since incisions still must be made on the breast in order to lift them.

-The physician has less control of the inframammary fold position.

2)  Periareolar Incision


+ Direct access to pocket for implantation.

+ Scar well hidden in the natural coloration of the areola.


  – Potential for loss of nipple sensation.

– The nipple may be a source of bacterial contamination of the implant during insertion.

3)   Inframammary Incision


+ Pocket is easily accessible and provides direct visibility for implant positioning.

+ In patients with significant folds, the scar is hidden underneath the breast.

+ If a lift is required, this incision will be incorporated into the lift.


– If a patient has very small breasts or undefined breast fold, the scar may be visible.

– Scar may be seen when you are lying down.

4)   Transumbilical Incision


+Avoids any scars or incisions on the breasts


–   Can only insert saline breast implants which are inflated once they are in the breasts.   Cannot insert silicone breast implants.

– While leaving the breasts free of scars, this approach makes it difficult for the physician to create a precise pocket, control bleeding, and position the implant where intended. Dr. Gilbert Lee at Changes Plastic Surgery does not offer this type of incision.

Breast augmentation can be a life-changing procedure, elevating self-esteem, and improving body contour through better bust to hip balance.  Don’t let a poor choice of incision ruin your otherwise satisfying surgical outcome. Make an educated incision decision with these tips and with the guidance of your plastic surgeon.

For more information on breast augmentation, breast implants and implant sizing read our blog .   Questions?  Contact us today.

Copyright 2014 Jill Darrah for Changes Plastic Surgery & Spa


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