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Incision Decision: What You Need to Know about Breast Aug Incisions

At the Maryland Institute of Plastic Surgery, every one of our breast augmentations is entirely unique and designed for the specific anatomy, aesthetic goals, and lifestyle of each patient. Many factors come into play, and we’ll help you determine the ideal size, shape, and type of implant for you.

Another one of the most significant decisions you and your surgeon will make is where to place the incision needed to insert your implant. Generally, patients choose between three standard options:

  • Inframammary Incision
  • Areolar or Periareolar Incision
  • Transaxillary Incision

We understand just how important this decision is and will work with you to ensure you are fully informed before making a choice. Below, we’ve broken down each approach and outlined the pros and cons associated with each incision.

Read on, and know that at the Maryland Institute of Plastic Surgery, you’re working with expert, artistic, board-certified doctors.

Breast Incision Options

There’s no single “right” option when it comes to your incision decision. Depending on your unique needs and goals, we’ll build a treatment plan to create a natural-looking, easily hidden augmentation without visible scarring.

No matter what approach you choose, the sutures we use will dissolve on their own. It’s also important to note that not every type of implant works with every type of incision. Some placements and implant types and sizes are only suited to particular incision placements. We’ll discuss all of this with you in-depth during your in-person consultation at our Baltimore, MD office.

Inframammary Incision

By far the most common surgical approach, inframammary incisions (also known as “the crease”) are placed under the breast fold. For most women, even moderate breast volume will easily conceal this crease, making it an ideal breast enhancement surgery option.

Your surgeon will create an opening under the breast, form a pocket, and then carefully place and position your implant. Surgeons tend to prefer this approach due to its higher degree of control when positioning implants. Patients, on the other hand, appreciate this incision placement as there’s no risk of affecting nipple sensation, and it’s easy to conceal. Finally, this incision is ideal for reuse in any subsequent breast surgeries, if necessary.

The only real “drawback” is that this incision can be visible on some women, especially if lying down.

Areolar or Periareolar Incision

Areolar or periareolar incisions, on the other hand, are placed entirely around the dark outer edge of the areola (nipple), or in a semi-circle around the lower half of the nipple (periareolar). Your surgeon will then insert the implant through the opening.

Benefits wise, this incision placement boasts a small opening that typically heals well. Any scarring will be well-concealed or almost invisible, blending in with the texture and color of the nipple. If there’s any scar tissue, it will only be visible without clothes. It also allows a high degree of precision when your surgeon places the implant and is easily used in any necessary breast surgeries down the line.

Aside from these many benefits, this positioning may not be suited for patients with very small nipples as it may not be concealable. Areolar incisions also can complicate breastfeeding, as the surgery involves milk ducts on either breast. There is also a risk of losing nipple sensation, as this incision severs nerves in the area. Finally, in some rare cases, the scar can become raised, discolored, and at worst noticeable.

Transaxillary Incision

As for the transaxillary approach, this incision is located in the armpit crease. If you have not had a prior breast enhancement, prefer a saline implant, and do not require a breast lift, this can be the ideal option for placement. Your surgeon will create a small incision in the armpit and then form a pocket for each implant in the chest wall. Once your implant is placed in this pocket, it will be filled with saline.

As with every incision option, the transaxillary approach has its own pros and cons. In terms of advantages, this approach boasts incredibly well-concealed scars. The majority of patients who choose this option do so because they want to avoid any scarring on or near their breasts. It also poses no risks to breastfeeding or loss of nipple sensation.

However, transaxillary incisions mean your surgeon cannot directly feel or visualize the breast tissue, which results in slightly less precision and control in implant placement. Additionally, some patients find their armpit scar can be seen when wearing sleeveless tops and may make shaving more challenging. A minority of patients may lose sensation surrounding the scar. Finally, this incision cannot be reused in any future surgeries.

Schedule a Consultation

If you’re considering breast augmentation, the best way to determine what incision approach and implant size, shape, and type will best fit you is to schedule an in-person consultation at our Baltimore or Columbia, MD offices.

We’ll review your medical history, record measurements of your anatomy, and help build a personalized treatment plant to achieve your goals. To get in touch, please give us a call at 410-744-0900 or contact us online today.