Modern Lipo

Summary:  When considering breast augmentation, most women focus more on selecting an implant size and type than on where the incision will be placed. However, considerations such as size, shape and style of implants can all help determine which incision points are possible. What impact can incision placement have on your final look?

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Incision Options

There are three incision placements for breast implants that are most widely used and recommended by cosmetic surgeons: inframammary fold incision, periareolar incision and transaxillary incision.

The inframammary fold incision (beneath the breast) is the most widely used point of entry for implant placement. Especially ideal for women with mild to moderate ptosis (droopy breasts) and fuller natural breast volume, this incision point can be well-camouflaged after surgery because the augmentation typically adds enough breast volume to cover the scar. Many surgeons prefer this approach because it offers easier access to the complex muscular structure and glands of the breast, allowing for a more accurate creation of the perfect pocket for implant placement.

The periareolar incision (around the nipple) allows the scar to be almost completely concealed thanks to darker pigmentation in this area, offering an attractive choice for women concerned about the visibility of an inframammary incision. Some surgeons believe that this incision point may increase the risk of capsular contracture due to its proximity to the higher bacterial levels within the milk ducts. However, this speculation has not been definitively proven in clinical research.

For patients with smaller nipples that make the periareolar incision less than ideal or those with insufficient breast tissue to disguise an inframammary fold incision, the transaxillary incision presents a third option. This endoscopic technique requires significant surgical skill, and the much smaller incisions mean silicone implants are often not a possibility. However, the transaxillary incision, which is hidden in the underarms, leaves the breast surface itself with no visible scars.

Specific Considerations

As you begin looking more deeply into breast augmentation, you’ll discover that incision placement is just one of many factors to think about. Here are some specific questions to consider and discuss with your cosmetic surgeon at your consultation:

  • What is your natural breast shape? – A very perky breast shape with little natural breast tissue may make the inframammary fold incision a less desirable option since there may not be enough breast volume to cover the scar. Alternatively, for women with tuberous breasts, the inframammary fold incision may be the only option because of the complexities of correcting this issue.
  • Do you plan to breastfeed? – The periareolar incision is not ideal for women who plan to have children in the future and desire to breastfeed, as this technique carries a small risk of compromising the complex structure of milk ducts.
  • Do you need a breast lift? – For women seeking breast implants and a lift, the surgeon will have to keep both procedures in mind when determining which incision points are possible for each case.
  • Saline or silicone? – Silicone implants require larger incisions because they are full-size at the time of insertion, unlike saline implants, which are filled after placement. The inframammary fold incision will likely be the best option to accommodate silicone implants of larger volumes.

Working together with your surgeon can help you become more informed about which incision options can help you reach your cosmetic goals. The first step toward getting the best results from your breast augmentation is to select an experienced cosmetic surgeon with extensive experience in breast augmentation; once you’ve found the perfect surgeon, all the other decisions should fall neatly into place.

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