Breast augmentation is a highly customizable procedure.  Implants vary in size and type.  There are also different options for incisions and implant placement.  These points will all be discussed during consultation with your plastic surgeon based on your aesthetic goals and clinical examination.  It’s helpful to be as informed as possible when considering breast augmentation.  Here are some of the basics about the three most common incision placements used for breast implant surgery.

Breast Augmentation Incision Placement Options

The three main incision placement options for breast augmentation are inframammary, periareolar, and transaxillary. Each of these options has its own advantages and disadvantages, and the best choice varies depending on your presentation and cosmetic goals, as well as the type of implant being used.

Inframammary Incision

The inframammary approach — also known as a crease incision – is the most common technique used in breast augmentation. With this technique, a horizontal incision is made in the crease below the breast, or the inframammary fold.

One major advantage of an inframammary incision is that this approach allows for excellent visualization by the plastic surgeon.  It enables precise creation of the implant pocket.  The scar is concealed within the breast fold as the implant settles into position.  This approach may reduce risk of capsular contracture given that the least amount of breast tissue is divided during the surgery.  The inframammary incision also carries the lowest risk of altering nipple sensation or breastfeeding ability as compared to other incisions.

A potential disadvantage of the inframammary incision is that the scar may be visible when lying down or in certain articles of clothing.  Scar healing depends on different patient factors as well as compliance with post-operative recommendations regarding scar massage and topical treatments. 

Periareolar Incision

The periareolar incision follows the junction between the areola and breast skin in a semicircular pattern.  A primary advantage of the periareolar incision is that scarring is well concealed within the pigmentation and texture of the nipple areolar complex.  There are limitations related to the periareolar incision. In some cases, patients may not be good candidates for periareolar incision placement because the nipple areolar complex is too small, particularly when undergoing augmentation with silicone implants. Another disadvantage is that there is risk of damaging nerves in the area that may result in a loss of sensation and difficulty breastfeeding.  If revision surgery is required in the future, there is also increased risk of nipple retraction if the periareolar incision is used again.  Risk of capsular contracture may also be higher given that more breast tissue is divided during the approach.

Transaxillary Incision

A transaxillary incision is created within the crease of the armpit. It may be used for saline implants, however allows for less precise implant placement given more limited exposure.  The transaxillary approach may be an option for patients undergoing primary breast augmentation and are not combining breast augmentation with a breast lift. Once a transaxillary incision is made, the plastic surgeon places the deflated implant within the pocket and then fills it with sterile saline.  Scars may be well concealed within the underarm region, however some patients may find them more visible in swimwear or sleeveless tops.  This approach may not be performed for breast implant revision given difficulty in visualizing and adjusting the pocket.  

Choosing the Best Incision Placement

The best incision placement for breast augmentation depends on your unique anatomy, goals, and other surgical factors including implant type and size.  Dr. Power will help choose the best option for you during your assessment.

Schedule a Consultation

To schedule a consultation with Dr. Power, call her Toronto office at (416) 962-1010 or request your appointment through our online form.  

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