The four most commonly used breast augmentation incision options are: inframammary (breast crease), periareolar (lower areola), transaxillary (armpit), and transumbilical (belly button). This post reviews the pros and cons of each one and the preferred choices used by our board-certified plastic surgeons when they perform breast augmentation in Denver, Colorado.
The inframammary incision is the most frequently chosen approach. Its many advantages include:
- The resulting scar hides well in the breast crease and is inconspicuous after it fades.
- It provides an extremely reliable, safe means of accurately inserting breast implants.
- The tunnel made for implant insertion causes minimal disruption of the milk ducts.
At The Center for Cosmetic Surgery, Dr. Vath, Dr. Steinwald, and Dr. Wolfe believe that tunneling behind the breast rather than through it reduces the risk of capsular contracture and infection.
The periareolar incision can create a nicely hidden scar at the border of the areola. This approach may not be feasible for patients with small areolae using larger silicone gel breast implants. During this technique, a tunnel must be made through the breast tissue in order to place the implant behind it. (Learn why our plastic surgeons prefer to place breast implants behind the chest muscle in this blog post.) Occasionally, upon pectoralis (chest) muscle contraction, patients can get puckering of the scar from the muscle pulling on the healed tunnel attached to the scar. Nonetheless, the periareaolar incision can be an excellent choice for patients with smaller breasts and defined, larger areolae.
Underarm & Belly Button Options
The transaxillary and transumbilical approaches are generally not recommended for silicone breast augmentation due to the risk of injuring the integrity of the shell during insertion. The revisional surgery rate is higher when these incisions are employed and the underarm scar can be noticeable in some patients when they raise their arms in a tank top, dress, or swim suit. These approaches sound attractive due to the avoidance of a breast scar. However, the inframammary and periareoalar approaches are considerably more prevalent because of their reliability, predictability, and extremely well-tolerated, hidden scars.