Choosing the Right Breast Augmentation Incision: Your Complete Guide to Making an Informed Decision

When considering breast augmentation, one of the most crucial decisions you’ll make involves where your surgeon will place the incision. In breast augmentation, there are basically four types of incision available. These include the inframammary incision (under the breast), transaxillary incision (under the armpit), periareolar incision (around the nipple), and trans-umbilical incision (inside the belly button). Each approach offers distinct advantages and considerations that can significantly impact your results, recovery, and long-term satisfaction.

Inframammary Incision: The Gold Standard

The inframammary incision is by far the most common approach for breast augmentation surgery. These incisions are made under the breast, in the fold of skin where the breast meets the torso. This technique has earned its popularity for several compelling reasons.

Advantages:

• An inframammary incision usually leaves a small, fine-line scar, only 1.5 – 2 inches in length. The natural skin fold typically hides the scar.
• First, the incision is distant from the nipple and areola, so it’s less likely to get contaminated by skin bacteria that can inhabit those areas.
• This option avoids the milk ducts, which means there should not be any complications with breastfeeding.
• This incision can also be reopened if you ever need to remove, replace, or revise your implants.

Considerations:

• One con of this incision type is that if you decide to change the size of your implants in the future, the inframammary incision cannot be reused, and a different incision will have to be made.
• Young women, thin women, or women who have not had children yet and have no crease under their breasts may have a more visible scar with this procedure.

Periareolar Incision: The Border Approach

A periareolar incision is typically made along the curve of the bottom of the areola, or nipple, right where the darker colored skin meets the lighter colored skin. Periareolar incisions are typically made around the lower, outer edge of the areola. There, the natural change in pigmentation hides the scar as the areola meets the skin.

Advantages:

• Most patients with this type of incision find that their scar heals very well. When performed by a skilled surgeon, periareolar incision scars can be close to invisible.
• This incision type provides surgeons with greater control over bleeding and the final surgical outcome due to the proximity to the breasts.

Considerations:

• This decline is due to the discovery that the periareolar approach is likely associated with a higher rate of capsular contracture than the inframammary incision.
• In addition, on average, the periareolar scar is more visible to patients when they look in the mirror, as the scar is at the focal point of the breasts. While the very best periareolar scars (probably less than 25%) fade remarkably well, the majority of the scars are visible to patients and their partners.
• It can also damage milk ducts, so this incision type is typically not recommended for younger women who plan to breastfeed their children in the future.

Transaxillary Incision: The Armpit Approach

The third type of breast augmentation incision is the transaxillary incision, which is made inside the armpit. Once the incision is made, your surgeon will create a pathway for the breast implants to be placed and then moved into position.

Advantages:

• The advantage of trans-axillary augmentation is that there is no scar on the breast itself.
• The beauty of the transaxillary approach to breast augmentation is that no scars occur on the breasts. Often, the axillary scar fades and is so well hidden that it nearly appears the patient has had a “scarless” augmentation.
• The breasts themselves are untouched, which means there is minimal risk of damage to the milk duct or nipple.

Considerations:

• But in warmer areas where you may wear sleeveless blouses and tank tops, the noticeable scar may be an issue.
• Some women also find they have a loss of sensation in the armpit from the incision. And this incision cannot be used if revision surgery is needed.
• Transaxillary augmentation requires specially designed instruments.

Trans-Umbilical (TUBA) Incision: The Belly Button Method

A trans-umbilical incision, also called at TUBA incision, is a popular incision type in which empty implants and inserted through the navel and up to the breast, then inflated. However, this approach comes with significant limitations.

Advantages:

• The scar is hidden inside the wrinkles of the naval, which means it is virtually undetectable.
• Compared with other types of incisions, umbilical incisions come with shorter recovery times.

Considerations:

• With the TUBA incision, surgeons perform quite a distance away from the breasts, giving them less control and precision over pocket creation and implant placement.
• This incision is only an option for saline breast implants. As you can imagine, the belly button gives your surgeon only a small space to work with, which means silicone implants are far too large to be passed through.
• Lastly, manufacturers often do not honor an implant warranty if it is placed using TUBA. Because of these potential problems, our surgeons do not recommend the TUBA approach.

Making the Right Choice for Your Body

As you can see, there are many factors to consider when choosing the right incision for your breast augmentation procedure. Fortunately, you do not have to make this decision on your own! If you are considering breast augmentation, it is best to consult with an experienced plastic surgeon in your area and discuss your options.

For patients seeking expert care in Connecticut, Breast Augmentation Ridgefield procedures are available through Dr. Chang Soo Kim’s practice. Drawing from his extensive surgical experience and academic training, Dr. Chang Soo Kim provides comprehensive cosmetic and reconstructive surgery. Dr. Kim’s cosmetic surgery techniques enhance one’s natural beauty without appearing artificial or overdone. Committed to reconstructive surgery with best possible functional and cosmetic results, he is capable of tailoring surgery to a patient’s specific needs and expectations.

He received his medical degree from Yale School of Medicine and has been in practice for more than 20 years. Dr. Chang Soo Kim performs cosmetic plastic surgery and non-invasive cosmetic treatments for the face, breasts and body in Stamford CT and surrounding areas such as Greenwich, New Canaan, Norwalk, Westport, Darien, Wilton, Weston, Easton, Fairfield, Bridgeport, Trumbull, Ridgefield, Danbury, Monroe, Milford, Bedford, Armonk, Mt Kisco, Bedford Hills, Rye, Harrison , Mamaroneck, Larchmont, White Plains, Scarsdale, Westchester County, Fairfield County.

Factors That Influence Incision Choice

Several factors will help determine the most appropriate incision type for your specific situation:

• Implant Type: Most silicone breast implants need a 4-5 cm incision, but a saline breast implants only needs a slightly smaller incision.
• Body Anatomy: Women have various areolar sizes, which can influence which incision is ideal in a particular case. Women who have a smaller areola may not be able to have a 4-5 cm incision for placing a silicone breast implant.
• Future Plans: Consider whether you plan to breastfeed or may want revision surgery in the future.
• Lifestyle: Your clothing preferences and activity level may influence scar visibility concerns.

The decision about incision placement is highly personal and should be made in consultation with a board-certified plastic surgeon who can evaluate your individual anatomy, goals, and preferences. Scarring levels vary from patient to patient, but most women will have little to no visible scarring after breast augmentation. With proper surgical technique and post-operative care, all incision types can heal beautifully, giving you the confidence and results you desire.