Breast Augmentation: Cost, Reviews, Photos

Breast augmentation armpit incision is not invisible. It can be seen with your arms raised and it cannot be small due to the size of the implant.

Typically it is a minimum of 2 inches in length. Incision for silicone implants via axilla/armpit (Otto Joseph Placik, MD, Chicago Plastic Surgeon)

Breast augmentation armpit incision for breast implants has more complications.

With you anatomy, in New York City, we would do an incision in the fold under the breast for breast implants. This fold becomes much deeper after breast augmentation, and hides the scar. Safest and best results. Axillary or inframammary incision for small nipples (George J. Beraka, MD (retired), Manhattan Plastic Surgeon)

Axillary or inframammary incision for small nipples

You have ONLY 2 options for incision, the axillary or the inframammary. Each has benefits and down side risks.

Please become informed of these risks and try and make an intelligent decision. I personally would use the infra mammary.

But that is me. From MIAMI Incisions for silicone implants (Darryl J. Blinski, MD, Miami Plastic Surgeon)

Incisions for silicone implants

There are 4 main incisions use for breast augmentation:

• The fold below the breast (works for all implants and every patient)
• Areola (junction of the pigmented nipple with the breast skin)
• Axilla (breast augmentation armpit incision)
• Belly Button (TUBA)

I personally perform the top 3, and consider the TUBA a non-controlled gimmicky technique. With silicone implants, you need a 4.5 to 5 cm long incision to avoid damaging the implant during insertion.

Your areola look very small, so unless you extend the periareolar incision onto the breast itself, you cannot use this approach. This leaves the breast augmentation armpit incision and the fold. You can put silicone implants in through the armpit, but it is technically more challenging for the surgeon. (Michael A. Bogdan, MD, FACS, Dallas Plastic Surgeon)

Breast implant incision choices

With the gel implants, the belly button is not an option. Breast augmentation armpit incision requires a fairly long scar so how much better is this than the crease? Not much really. Your areolas are too small so these are out. I’d personally recommend the crease for you. (Richard P. Rand, MD, FACS, Seattle Plastic Surgeon)

With sub-muscular placement of breast implants, breast augmentation armpit incision is best incision

While the learning curve is high for placement of breast implants behind the muscle through the arm pit incision, I believe it is by far the best and safest incision. What really is done is you make a very small incision in the direction of the wrinkles of the armpit, you make a sub cutaneous dissection to the pectoralis muscle which is right there and then a blunt dissection behind the muscle. The implant never touches the breast tissue and therefore it is much less likely to get hard (capsular contraction).

The scar almost always heals beautifully and is almost not visible. It is not a good approach if the implant is to be placed under the breast tissue because of potential bleeding. You must make sure that if your surgeon is going to use this approach that they have a lot of experience with the technique. Ask to see pictures of the results. Know all options for incision for breast implant placement (Carl W. Lentz III, MD, Orlando Plastic Surgeon)

Incision placement for breast implants

You basically understand the pros and cons. One thing to understand is that the arm pit incision has the highest rate of implant malposition requiring revision, frequently via the inframammary incision.

You may want to consider the inframammary incision. Transaxillary (arm pit) breast implants for augmentation (Scott E. Kasden, MD, Dallas Plastic Surgeon)

Transaxillary (arm pit) breast implants for augmentation

There are a number of possible incisions that can be used for augmentation. I use only the periareolar and inframammary incisions for a number of good reasons.

Both allow much better visualization of the area being opened and, thus, more accurate placement of the implant.

The majority of misplaced implants I have seen are from other incisions, especially the axillary one.

Also, I do not believe that anyone should attempt placement of anything other than a saline implant through these other incisions.

You can roll up a saline implant, making it easy to get through the long subcutaneous tunnel created by these other incisions.

Getting a silicone implant through this tunnel requires a significant amount of manipulation and force, markedly increasing the risk for rupture of the implant or other problems. The periareolar and inframammary incisions have none of these problems, unless the areolae are very small.

Also, about the only scar I have ever needed to revise for an implants is the axillary one. Some people tout the fact that these other incisions are away from the breast and therefore are less likely to cause numbness. In fact, when studies have looked at this, the thing that causes the numbness is opening the deep tissues to make a place for the implant. In other words, the numbness is the same regardless of the incision used.

The larger the implant, however, the more numbness you will have, since a larger implant requires a larger dissection to have a place to put it. (Robert T. Buchanan, MD, Highlands Plastic Surgeon)

Each surgeon has an approach that they have learned and feel most comfortable. You will need to decide where the scar is best for you. Every person has ideas as to where the scar will bother them the least. Future considerations are important as well as how you feel at this time. A lot of people like to avoid scar on the front of their breast where they will most likely see the scar. The periareolar scar generally heals very nicely but it is a scar on the front of your breast where your eye will easily see it.

The periareolar scar also divides breast tissue which could expose the implant to bacteria during insertion. (Marcus L. Peterson, MD, Saint George Plastic Surgeon)

While my colleagues might disagree. Its much easier to do a capsullectomy or implant exchange through an inframammary or periareolar type of incision. I hope your wife never needs another procedure but, if she does, she’ll end up with a second scar if she selects an armpit approach. (Robert Frank, MD, Munster Plastic Surgeon)

No single best incision for breast implants in all cases

First, a few misconceptions about various factors influencing the choice of incision.

One is nipple sensation; all recent studies show that the periareolar location does not have a higher incidence of sensory loss as compared to others, though many patients still seem to be told that.

Another is capsular contracture, which should not be affected. In my view, you want the surgeon to have the most direct access without leaving an obvious scar. That way the space for the implant can be created with precision and any potential problems such as bleeding can be dealt with directly.

Periareolar is better under these criteria than axillary. Another issue is the likelihood of future surgery, for implant replacement later in life or any adjustments that might be desired earlier on.

These are much more difficult to do from the axillary approach and so there is a good chance that another scar would be made at some point anyway.

Plus the axillary scar will be more exposed and if there are any issues at all it becomes an obvious tipoff about the implants. (Richard Baxter, MD, Seattle Plastic Surgeon)

Incisions for Breast implants

There have already been a lot of great answers here. The only thing I might add is that much of the scar quality depends on yourr wife’s skin type and natural healing tendency. Scars placed around the nipple can be conspicuous if they don’t heal well. Even a dark or raised scar will not be readily visible if it’s in the axilla or under the breast. (John LoMonaco, MD, FACS, Houston Plastic Surgeon)

Best incision for breast implants

In the end, the decision should be your wife’s decision together with her doctor. Having said that, the transaxillary incision limits the size of a silicone implant that can be placed. Likewise any secondary surgery is more difficult through that incision. Just yesterday, I evacuated a ruptured silicone implant and did a partial removal of the capsule on a patient who originally had armpit incisions.

We had to use a new incision (fold). As far as the choice of incisions, most women spend more time with their armpits visible in bathing suits, strapless dresses, etc. Than they do without clothes. So if there is any problem with the transaxillary incision, it will be visible to a lot more people. (Francisco Canales, MD, Santa Rosa Plastic Surgeon)

Periareolar breast implants incision

Each physician has their own way they prefer to do a procedure. I like the periareolar incision best because it allows you to easily position the implant and if you need a revision you can use the same incision.

Although you can say the same for the infamammary incision, the periareolar is less visible and usually heals with a better scar. I don’t like the axillary approach because, it implants can end up too high and you can’t do revisions through it and it is very difficult to insert large silicone implants this way.

But to tell you the truth, it is your wife’s body and ultimately her choice. If she chooses wrong, she may end up with more than one incision where only one would had done. (William B. Rosenblatt, MD, New York Plastic Surgeon)

Periareolar or armpit breast augmentation incision

If you push your wife into a periareolar incision you may regret it for the rest of your married life. As you have read here, there are advantages and disadvantages to each incision type. The only thing that I have to disagree with is the statement that ALL future surgery performed in a armpit patient requires an additional incision somewhere else on the breast.

This is simply not true. I have personally performed revisionary surgeries on patients with previous armpit incisions through the same scar. It merely depends on what the revisionary surgery entails. Keep your marriage and let her make the final decision. Good luck! (Kenneth R. Francis, MD, FACS, Manhattan Plastic Surgeon)

There are pros and cons to each breast augmentation incision option

As others have said, since you don’t have a distinct fold, an inframammary scar may be quite visible, especially with your skin type.

Where I differ with some of the other posts, is that I also believe a periareolar scar will potentially be very visible.

I always hear or read from surgeons how the periareolar approach is so discreet.

I disagree. It can heal discreetly, but not always. There is an unpredictably to it, as well as the fact that some areola/skin borders aren’t amenable to hiding a scar.

And hey let’s face it, if it doesn’t heal perfectly, it’s right there on the front of your breast! Beyond the issue of the scar itself, there tends to be more contour depressions and asymmetric areola shape changes from periareolar scars.

I would certainly consider a armpit approach for you – this is the most discreet incision, if placed high in the axilla.

I don’t understand other plastic surgeons who claim it is more visible – perhaps they’re placing the scar low where it is visible on the side of the chest – not a good way to do it!

Seek a plastic surgeon who is comfortable and experienced with all these techniques so you can discuss all your options. (Douglas J. Mackenzie, MD, Santa Barbara Plastic Surgeon)

Choice of Breast Augmentation Incisions – Which is Best?

IF there was an absolute, “no doubt about it”, “don’t you even dare think about another” Breast Augmentatin access incision the vast majority of Plastic surgeons would be using that breast incision. Unfortunately, breast augmentation incisions have both positive and negative attributes so it comes down to your surgeon and you to decide which set of plusses you are willing to accept over which potential drawbacks.

I have used all conventional breast augmentation incisions over the years and found NONE to match the versatility and, most importantly, the re-suability of the periareolar incision. The incision approaches the future breast pocket through its roof NOT through a low door (breast fold incision), nearby room’s door (arm pit) or through the house’s front gate (belly button). No other breast incision match the visibility provided by the around the areola breast incision. None can be used to either lift the breast or effect small accurate changes to the pocket, if needed, AND unlike the breast fold incision, the periareolar incision does NOT weaken the floor of the implant causing earlier implant descent.

The periareolar incision would be my choice. I would suggest you ask your surgeon to use temporary implants in the OR (sizers) which can be filled until the ideal fill and look is achieved.

This then more accurately directs the choice of the best corresponding breast implants. (Peter A. Aldea, MD, Memphis Plastic Surgeon)

Breast augmentation incisions

There is no right answer but if you don’t have crisp inframammary folds and if you do have a sharp edged areola in a darker skinned person, the infra-areolar breast incision would usually be my choice though I am more of a fan of the crease for most people. (Richard P. Rand, MD, FACS, Seattle Plastic Surgeon)

You are in a quandry that many patients find themselves in. Your answer depends on how you live: if you like to be in skimpy swimsuits then a nipple or axillary incision may be for you. If you seldom wear a swimsuit like a bikini then it won’t matter.

I find that the inframammary breast incision is easier to work with and I have the fewest problems with it. However, I have successfully used the other incisions too. You need to weigh the advantages and disadvantages of each and discuss it with your surgeon. (Victor Au, MD, Chapel Hill Plastic Surgeon)