Breast Augmentation: Cost, Reviews, Photos

Choose the right surgeon – your scar will be barely visible no matter where it is

The most important factor in scar appearance and the look of your breasts is surgeon selection. Regardless of where you choose to have your scar, make sure you go to a board certified plastic surgeon who does a large volume of implants using the incision you choose.

Ask your surgeon to see before and after pictures of their results – choose a person who has a shape and skin color similar to yours to get the best idea of what your result will be. You are a candidate for any of the three types of incisions – axillary (armpit), nipple areola complex (on the border of the colored portion of skin), and inframammary (in the fold under your breast).

Which incision is best for breast augmentation

Axillary – the advantage is there are no scars on the breast whatsoever. Depending on your healing, the scar may be slightly visible in sleeveless clothing, but after the first year will be difficult to see even close up.

This incision has the highest rate of implant malposition of the three – it is critical that you see a surgeon who does this approach regularly if you choose this incision.

Inframammary – the scar hides underneath the breast and cannot be seen looking at the breasts straight on. It may be visible when lying down without a bra depending on your healing. This incision has the lowest rate of capsular contracture (hardening of the breast over time due to scar tissue).

Which incision is best for breast augmentation question

Nipple Areola Complex – the scar is camouflaged by the color change between your breast skin and areola, but may be seen when looking at the breasts straight on.

The Safest Incision For Your Breast Augmentation Is To Place Incisions Along Folds of Breasts (Grant Stevens, MD, Los Angeles Plastic Surgeon)

The Safest Incision For Your Breast Augmentation Is To Place Incisions Along Folds of Breasts

Which incision is best for breast augmentation photo

The possible choices for incision for breast augmentation include the nipple, the axilla or armpit, or the fold of the breast. If your nipple is too small to allow for a big enough incision to technically get the implant in, then obviously that is out for an option.

Going in under the arm also poses a problem with a silicone implant like you are considering (350 ml). Silicone implants come prefilled and require a specific length of incision to get it in without excessive stress on the implant.

Making a tunnel wide enough to fit a silicone implant from the axilla down to the breast also creates a problem. The tissue has to be opened up so much that the implant would be able to move around and not stay in the pocket we create under the muscle.Implant malposition is one of the most common complications when an axillary incision is used. Probably the safest incision in your situation would be to have the incisions along the fold of the breast.

Which incision is best for breast augmentation image

That incision provides great access to the pocket we make under the muscle, and we can make the incision as long or as short as we need to get the implant in without excessive stress on it. Another issue that has recently come to light is the problem of capsule formation (excessive scar tissue around the implant).

Recent studies have shown that the incidence of capsule formation is significantly higher through both the nipple and armpit approach. The incision on the fold of the breast has the lowest chance of capsule formation. All of the different incisions tend to heal as fine line little scars in the long run. I  hope this information helps give you more insight on which route to follow with your surgery. (Marie E. Montag, MD, Omaha Plastic Surgeon)

Incisions for Breast Augmentation

Which incision is best for breast augmentation scar

I think your concern about armpit incisions being visible during the summer, presumably because you will be wearing a bathing suit, is a valid one. For this reason, I would not place it there.

Regardless of the size of your nipple, (I think you are probably referring to your areola), I also think that is not the ideal place for a breast augmentation incision because of possibly a higher risk of capsular contracture due to a higher bacterial load in that area.

An incision in the inframammary crease (the fold where the lower part of your breast and your chest meet) will be concealed by your bathing suit and probably has the lowest capsular contracture risk. For these reasons I think that is the best place to place the incision. (Jonathan C. Weinrach, MD, Scottsdale Plastic Surgeon)

Incision placement

I would recommend a small incision in the breast fold. This is less visible (not visible in swimsuits) and provides a reliable and reuseable incision in the future for your implant exchanges in the years to come. Incision Approach (Mahlon Kerr, MD, FACS, Austin Plastic Surgeon)

Every implant requires an incision which will ultimately leave a permanent scar. Most women have scar results that are very acceptable no matter where their location is.

Each scar location has certain advantages. It is important to understand that, when using a silicone implant, a larger scar is required because this device is pre-filled when it is received from the implant manufacturer.

Saline implants allow the use of a smaller access site because they are empty when inserted and then subsequently filled with saline after their insertion into the breast pocket is accomplished.

Your concern regarding access through the areola is well noted and is not advised due to both the use of a silicone implant and also an implant of that size.

Although an areolar incision could be used, it would likely require an extension into the breast skin on either side. The axilla or armpit approach is not without its own limitations as the development of a breast pocket from this location can sometimes be less accurate than one chosen from a location in more direct proximity to where the implant will be placed.

There is also a sensory nerve within this region that, if cut, could cause a loss of sensation to the underside of the arm. Finally, since you have a slight natural breast fold, the use of an inframammary approach would not be unreasonable since the scars tend to heal quite nicely and are usually completely covered in most patients. (Melek Kayser, MD, Detroit Plastic Surgeon)

Incision Approach

Every surgeon has different techniques they like to use. Which technique is preferred depends on that particular patients assessment and implants being used.

For silicone implants my personal technique is primarily using the crease (IMF) approach, unless there is an assessment finding at the patient’s consult which would lead me to believe they would have better results from another approach. (Peter J. Capizzi, MD, Charlotte Plastic Surgeon)

Transaxillary Breast Augmentation for avoidance of breast scar

I believe the incision selection is one of the most important things for the patient and plastic surgeon to agree on. There are many ways to achieve a quality breast augmentation with minimal scarring. In your case I would avoid using the nipple incision because of the small nipple size, and even though scars heal well there, it is still in the middle of the breast.

I also believe the rate of capsule contracture is higher when using the peri-areolar or nipple approach. In your case either the transaxillary approach (armpit) or inframammary approach could be done. If you select the transaxillary approach make sure your surgeon is experienced in this technique. If your surgeon is experienced in transaxillary breast augmentation then it is certainly an excellent technique and keeps incision off the breast.

Alternatively, a very nice result can be obtained with an inframammary approach with barely visible scarring. I would suggest choosing either the transaxillary approach or the inframammary approach. (Steven M. Camp, MD, Fort Worth Plastic Surgeon)

Best Incision for Placement of Breast Implants.

This is a wonderful question that comes up, frequently. I don’t believe that either the axillary or the periareolar incision is best for placing a silicone gel implant for breast augmentation. Every incision for breast augmentation has advantages and disadvantages.

In our practice, we firmly believe that the inframammary fold incision (in the fold under the breast) offers, by far, the most advantages and fewest disadvantages. It allows for the most precise placement of the implant, lowers the risk of capsular contracture, and is less risky for the implant. When performed correctly, the incision heals beautifully and stays hidden. The goal is to have the best long-term result with the smoothest recovery, and the IMF incision offers this. Don’t Recommend Armpit Incision for Breast Augmentation (Dustin L. Reid, MD, Austin Plastic Surgeon)