Breast Augmentation: Cost, Reviews, Photos

Armpit best incision for breast augmentation

There are several options for implant placement: inframmary, periareolar, armpit/axillary, and TUBA (incision around the belly button). No matter where you have the incision, you will have to have a scar.

The inframmary incision and periareolar incision are two more common incisional placement by plastic surgeons. the armpit and TUBA are not commonly practiced.

Not many plastic surgeon perform these incision. There are risks of complications regardless of where you place the incision. I personally feel the least risks of complications out of all the incisional placement is the inframmary incision.

Also, if you wish to have the scar hidden, I feel the inframmary incision is the better choice, which is made along the natural crease of your lower breast border. When you stand up right, you can hardly notice the scar at all. (Kim-Chi Vu, MD, Portland Plastic Surgeon)

Best Incision Options for Breast Augmentation

You have many options when considering the incision location for your breast augmentation surgery. Aside from axillary or periaerolar incisions, you should also seriously consider an inframammary incision.

This incision will be well concealed within the creases beneath your breast, and also has many added benefits as compared to your other options. Because the location of the incision is much closer to where your surgeon will create the pocket for your implants, the direct access can give you a more ideal cosmetic result.

A more perfect pocket can be created, and therefore the end cosmetic result will be more ideal. Additionally, there are less risks of complications and infection with this approach, which works to your advantage. Ultimately though, it is your choice where you would like your final scar to be – and there will be a final scar. There are pros and cons to weigh for each approach, but it would be beneficial to you to consider an inframammary incision during your decision-making process. Armpit incision for breast augmentation (Frank Campanile, MD, Denver Plastic Surgeon)

Best breast augmentation incisions

I think all three best incision types are reasonable for you. There are three best types of incisions that can be used to place a silicone implant for breast augmentation (TUBA, through belly button, can only be performed with saline) :

1) Inframammary: This incision is placed at the breast fold. It is easily concealed since it is at a natural crease plus it is convered by clothing including the brassiere and bikini top. This incision offers the surgeon great access and control of the breast pocket.

2) Peri-areolar: This incision is placed at the border of the areola and breast skin. It is also concealed by clothing. It does result in an incision near/on the most sensitive and sensual part of the breast. It offers the surgeon very good access to the pocket and is particilarly beneficial for constricted breast syndrome cases.

3) Trans-axillary: This incision is in the arm pit. It is the only incision not on the breast that can be used to place a silicone implant. When placing silicone implants via this incision there are size limitations. Smooth silicone implants of up to 400-450 cc can be placed and smaller implants of about 300-350 textured can be placed. When performed with a scope this incision offers the surgeon good control of the pocket. Implant exchange in the future usually requires an inframammary or peri-areolar incision. (Remus Repta, MD, Scottsdale Plastic Surgeon)

Either incision will work

From the pictures submitted it appears that your candidate for both breast augmentation through the transaxillary or periareolar approach.

350 cc is a modest-sized implant and can fit through a 4-1/2 cm incision either periareolar or through and armpit, especially if he uses a funnel.

I would not personally recommend an inframammary fold incision since you do not have a lot of breast tissue and this incision would be highly visible.

You’re not getting enough volume were it would be certain that you will have a natural teardrop look to the breasts that will hide the incision.

I would recommend either going through the armpit or around the nipple. The armpit incision heals very well and is usually tucked high up into the armpit where it is hardly noticeable after it is completely healed. It is usually hidden in a pre-existing armpit wrinkle. (Patrick Hsu, MD, FACS, Houston Plastic Surgeon)

Armpit Incision for Breast Augmentation Because Nipples Are Small?

Armpit and nipple incision sites have been shown to have a higher rate of infection and capsular contracture. I prefer the inframammary or breast fold approach in most cases for this reason. When it falls in the breast crease the scar hides well. It is not visible in a bikini and not very noticeable in the nude, especially after the scars fade. (Michael Vennemeyer, MD, Southlake Plastic Surgeon)

Inframammary incision is best for breast augmentation

I don’t recommend either one. The best incision is the inframammary (under the breast) incision. I utilize a 2.8 cm incision for silicone gel implants in this size and a well placed incision under the breast “hides in the shadow” of the breast and is not visible. This also allows your plastic surgeon the best and most precision anatomically to place your implant. Finally it is the “route” with the lowest rate of complications as well. (James F. Boynton, MD, FACS, Houston Plastic Surgeon)

Best incision for Silicone implants

I will agree with many of the previous posts in that the other incision to consider is the inframammary incision. Axillary scars tend to heal well, but will be visible when you lift your arm up, wear sleeveless dresses, etc. In experienced hands, I believe that there will be no difference in appearance of your final breast augmentation whether the transaxillary or inframammary approach is used.

The difference resides in the fact that breast implants are not PERMANENT devices, there are risks of rupture and capsular contracture both of which require REOPERATION. You appear to be a young woman, so the chance that you will need another operation down the road are pretty high.

During the reoperation, most surgeons will go via an inframammary route over a transaxillary route for better visualization and more precision and control. That is one of the reasons that I prefer the inframammary route vs. transaxillary. The other is that with the inframammary approach, it is only visible when viewed topless from below. Transaxillary approach is OK for Silicone Gel implants (Stephen M. Chen, MD, Richmond Plastic Surgeon)

Transaxillary approach is OK for Silicone Gel implants

In breast augmentation surgery, the result depends on the experience of the surgeon. Many plastic surgeons will be critical of the transaxillary approach, because they prefer other approaches and certainly good results can be obtained from many different approaches.

You should be relieved and encouraged that you are a good candidate for transaxillary placement and this procedure has the great advantage that there is no scar on the breast. The axillary scars are for the most part, barely noticeable after several weeks.

Research seems to suggest that the incidence of capsular contracture is less after a transaxillary approach and future ability to breast feed is not affected as there is no incision through the breast tissue or ducts. (Bruce K. Smith, MD, Houston Plastic Surgeon)

Incision for silicone implants via axilla/armpit

The transaxillary approach was originally popularized for Japanese women with exactly your situation. However, silicone gel implants require longer incisions than saline. Your surgeon should measure the proposed incision for each site to see if a gel implant can be placed and how long the scar would need to be. If you object to the axillary incision even though it might be the most appropriate, there are ways to lengthen the periareolar incision either by extending the ends at the 3 and 9 o’clock position onto the breast skin since it can be hidden by a bra or bathing suit or by placing the incision outside the periareolar-skin border and trimming the skin to re-establish the skin-areolar junction.

An infra-mammary incision is best for larger silicone implants (Robin T.W. Yuan, MD, Beverly Hills Plastic Surgeon)

An infra-mammary incision is best for larger silicone implants

From your photo, it would appear that you’re a great candidate for an infra-mammary incision. When the scar is accurately placed, it will be concealed within the fold under your breast.

This incision can be made long enough (about 4 cm) to accommodate a 350 cc silicone implant. Personally, I would have trouble getting a 350 cc implant through an axillary incision, but this does not mean it can’t be done. I wouldn’t recommend it to anyone. Every surgeon has a different philosophy on these issues, I’m just presenting my own.

The underarm breast augmentation (Scott C. Sattler, MD, FACS, Seattle Plastic Surgeon)

The underarm breast augmentation

The under the arm, or trans-axillary augmentation is a very good choice to keep the scar off of the breast when the nipple is small, or there is no fold in which to hide a breast scar. I often use this approach for breast augmentation, and it can work well with both silicone gel and saline breast implants.

The saline implant will fit through a small incision, about an inch, and the gel implant will often require an incision of 4cm, or an inch and three quarters if the implant is large. The scar is hidden well high up under the arm, though for the first summer sun season the scar may be visible as you raise up your arm until it finally pales in and becomes difficult to see.

To keep the incision as small as possible you could choose a saline implant which will pass through a small incision under the arm, or even the small nipple that you have.

If you are concerned about a summer scar, the under the breast incision for a gel implant is very popular, but keep in mind that the scar will never tan and is a ‘forever’ white line under the breast.

Underarm versus nipple or inframammary incisions (Peter E. Johnson, MD, Chicago Plastic Surgeon)

Armpit incision for Silicone implants

As others have stated, there are 4 main incisions for placement of implants. Saline can be placed with any of the 4 incisions, but silicone (because it is pre-filled) does not easily fit through a small incision.

The most common incision for silicone is inframmary (crease at the underside of the breast). Its safe, tested and gives the surgeon excellent visibility.

Placed correctly, I have never had a patient complain about its location. It essentially hiden in most every type of clothing.

As for the incision and scar, its unavoidable but again, done well it can be well concealed. (Raj S. Ambay, MD, Brandon Plastic Surgeon)

Armpit incisions for breast augmentation

You may be a good candidate for this technique because of the small areola. The good news is that the scar is small and well hidden in the armpit. The bad news is that it often is difficult to position the implant into a proper postion behind the breast – it may ride up too high or be positioned too low.

It is occasionally difficult to control this problem with this technique. It is possible to either go subpectoral or submammary with equal ease from this technique, and both saline and silicone implants may be placed through this entry scar. Periareolar incisions are more difficult to place a large implant through when the areola is small, this is correct.

There is also some early evidence that the periareolar entry may lead to some mild contamination with bacteria around the implant if there is any bacterial contamination in the breast itself as you travel throught the breast to place the implant.

The time honored incisional technique is to go through the inframammary incision for placement.

This keeps the implant out of thebreast parenchyma and no serious contamination might develop strictly relating to the entry location.

All of this should be discussed with your Plastic Surgeon. Talk with your chosen Plastic Surgeon and I am sure all of the pros and cons will be discussed with you. (Francis (Frank) William Rieger, MD, Tampa Plastic Surgeon)

What is the best incision for my Breast Augmentation?

There are several different incisions that can be used for the placement of silicone implants. The “best” way is not the same for all patients, because it depends on multiple factors and is best discussed with your surgeon at the pre-surgical consultation.

However, you left out one incision in your question that I believe would be the best for you: the inframammary or breast fold incision. I would not count this incision out for you because of three main factors:

1. You have picked an average sized implant that can easily be placed through a small (3.5-4cm) well hidden incision in the crease.
2. You have nicely shaped breasts and it is therefore important to have the implants placed as accurately as possible. It is easier to cut the muscle and create a very nice cleavage with implants placed from underneath as opposed to being placed from way outside in the armpit.
3. You have small areola and making the incision there would be more obvious and less inconspicuous with silicone implants. (Erez Sternberg, MD, Jacksonville Plastic Surgeon)