Breast Augmentation Incision – What’s The Best for You?

Are you considering in getting a breast augmentation surgery? Are you wondering what’s the best incision for you is? Then you will probably find answers here.

I understand that deciding for the best breast incision is difficult. There are a number of techniques available to carry out the procedure and each has its own set of advantages and disadvantages. You have to determine what you want and what your priorities are because the place of incision matters.

Before you get yourself under the knife, you should be knowledgeable about your options especially if you have plans to breastfeed in the future. Although breast augmentation doesn’t stop you from nursing your baby, it might lower your breastfeeding success rate.

This page aims to answer the common breast augmentation incision questions and concerns. So, read more to know the details.

Things to Consider in Choosing the Best Implant Incision for You

I understand that choosing the best implant is challenging, especially that there are a number of options available for you and each of them offers a set of advantages and disadvantages. So, to help you decide here are some of the things that you should consider:

Your surgeon’s skill and comfort level in a specific incision approach matters. Some surgeons are expert in doing one technique and so-so in performing the other approaches. So, it would help if you discuss your surgeon’s expertise too.

For instance, the transumbilical technique is difficult to perform, but there are surgeons who are comfortable in performing it. If you want this type of incision, you can rely on Dr. Clayton A. Frenzel to perform it. He specializes in breast augmentation surgery and spent a year in specializing the art or aesthetic breast surgery, including TUBA.

The degree of visual and surgical control your surgeon will have. Yes, you read it right. The location of incision matters during the surgery because it can either make the process easier for the surgeon or make it more challenging.

📌To give you an overview, the incision in navel and armpit is difficult because it is not as visible as the one done in the breasts and areola the surgeon may use a tiny fiber optic cameral called endoscope to see the things going on inside and ensure that the implants are properly positioned. Meanwhile, incision under the boob and areola gives the surgeon more control and visibility.

The ability of the incision to provide access to create and dissect a surgical pocket without much damage to the surrounding tissues. When it comes to this concern, inframammary and areola incision give the surgeon a great access to perform the surgery but the latter has the tendency to affect the nerves and breast tissues that may increase your lower your breastfeeding success in the future. Meanwhile, TUBA (navy) and Transaxillary (armpit) don’t allow direct access to the breasts.

The degree of exposure of the implant to your own body’s bacteria. Areola incision is the only technique that exposes the breast implant to breast tissue and bacteria within it. This may increase the risk of capsular contracture.

Your preference regarding the final location of the scar. This is one of the most obvious things that you should consider. Where do you prefer the scar?

  • Inframammary incision hides the scar under your boobs. Unfortunately, if you want to increase your breast size in the future, the scar will move up and will be visible.
  • Transaxillary hides the scar in the armpit. This area also heals well and makes scar less visible.
  • Areola incision tends to heal very well and leave a very faint scar that it is almost invisible. But this may not be viable for women with small areola.
  • Transumbilical – The incisions are far away from the placement of the implants and decrease the risk of infection. Scars are also invisible.

Size of the implant. The size of the implants may also matter when you decide for the location of the incision.

  • Inframammary – With this technique, surgeons can make 3 cm to 5 cm incision. Silicone implant tends to have larger incision than saline implant for the same implant size. The downside with this is that it is difficult to increase breast size in the future because it can make the scar move up and visible.
  • Transaxillary – Silicone sizing is limited for this incision. Extra large silicone breast implants cannot be inserted. So if you want a large silicone implant this is not a great option.
  • Areola – If your nipple is small your implant size is limited.
  • Transumbilical – This is not applicable for silicone implant, but according to Dr. Frenzel, 86% are happy with their breast implant size.

Breast Augmentation Incision Types

Once you have decided to get a breast augmentation, you should schedule a consultation and discuss with your surgeon your options. The factors mentioned above are very important to consider. So, while we explore the different types of breast augmentation incision, keep it in mind.

These are the four breast augmentation incisions:


Breast Augmentation Inframammary Incision

This is the type of incision that most, even surgeons prefer because the scar is hidden under the breasts. In addition to this, the surgeon has great access to do what needs to be done, to create a dual plane pocket and release the pectoralis muscles.

This breast augmentation technique allows for more precision and works for both saline or silicone implant.

According to Dr. Mark Epstein, this approach results in “a lot less downtime and a lot less bleeding because there’s no need for any blunt dissection.” In addition to this, it has “the least amount of exposure to bacteria and the least amount of trauma to the breast tissue.”

This decreases the risk of capsular contracture but results in easier recovery and lower chances of revision. “Having tried several different options, at this point in my practice, I prefer the inframammary approach,” Dr. Epstein said. “It gives the greatest degree of control, the least amount of bleeding, the greatest flexibility to create the pocket the way that I want it, the least visible a scar and overall, I get the best cosmetic result.”

Pros
  • Direct visibility of pocket creation and implant positioning.
  • Scar is hidden under the breast fold.
  • Great approach for additional breast surgery.
  • Good technique for treatment of cases of mildly sagging or tuberous breasts.
  • Gives excellent access for placement of silicone gel implants.
Cons
  • Scar on the breast
  • Hard to hide the scar on small, tight breasts without deep folds.
  • Scar may be visible when you are lying flat.

Findings: This is the most popular and preferred incision site. Works for placing silicone or saline implant and good for women with tuberous or sagging breasts. Scar is hidden.


Breast Augmentation Axillary Incision

This technique places the implant through the armpit. This can be done in two ways.

First, the “blind” method. The surgeon does not use an endoscope when performing the procedure.

Second, the surgeon uses an endoscope (a small camera with a light on the end). This will be inserted into the pockets and will allow the surgeon to see what he or she is doing “inside” on a TV screen.

This works well with a saline implant. Unfortunately, for silicone implant, a bigger incision is needed to place the implant without damaging or weakening it.

This approach may not work well if you want a big silicone implant because it will need a large incision and will defeat the purpose of a hidden incision.

Pros
  • No scar on the breast
  • Scar often blends into skin crease well
  • Scar is hard to detect
  • Has the lest visible augmentation scar
  • Endoscopic technique provides full visibility and precise surgical control of pocket creation, bleeding and implant placement
Cons
  • Poor scar may be visible in sleeveless tops
  • Limited in treatment of some cases of mildly sagging or tuberous breasts
  • Silicone implant needs longer incision, the scar can be difficult to hide in small underarms.
  • Additional surgery, such as removal of scar tissue from around the implant (capsulectomy) may be difficult with this approach.
  • Small risk of numbness of the skin around the underarm and upper arm.
  • Risk of scar tissue band formation under the axillary scar.
  • More challenging than inframammary and areola because the incision is far from the breast.
  • You have to look for a surgeon that performs this regularly because not all do.

Findings: Best option if you don’t want a scar on your breast. This works well for saline implants but not for silicone implant as it may entail larger incision. Also, there is a higher risk of the implant to be out of position using this approach.


Breast Augmentation Periareolar Incision

For this technique, the incision is placed around the nipple. This works both for silicone and saline implants. However, the process may entail the exposure of your ducts to bacteria which increases the risk of capsular contracture.

But when it comes to concealing scar, this is a very good spot. It heals well and the scar is almost invisible. This is a good option if you want your areola and nipple re-shaped, re-sized or re-positioned during the surgery.

Pros
  • Direct visibility of pocket creation and implant positioning.
  • Scar may be well hidden by areola tissue.
  • Good technique for additional breast surgery.
  • Good approach for treatment of cases of mildly sagging or tuberous breast.
  • Good choice if you want to re-shaped, re-sized or re-positioned your nipple.
Cons
  • Most women do not want this sensitive area operated on.
  • Exposes the implant to breast tissue and bacteria within the breast tissue.
  • Implant exposure to bacteria increases the risk of capsular contracture
  • Some sensory nerves around the areola are cut. This may increase the risk of loss of nipple sensation.
  • Increases risk of breastfeeding problems in the future.

Findings: This approach is good in placing saline implants, hiding scar and addressing tuberous or sagging breasts. The downside of this technique is that it is done in a sensitive area so nerves can be disrupted and breastfeeding success is affected. Also, this will not work for women with small nipples.


Breast Augmentation Trans-umbilical Incision

This approach places the incision within the navel and is also referred to as belly button, navel or trans-umbilical incision breast augmentation, hence, the name TUBA.

In this approach, the incision is at the umbilicus (navel) and places the implant pocket without visible surgical scars. Unfortunately, this is not applicable for pre-filled silicone-gel implants because it might damage the elastomer silicone shell of the breast implant device during manual insertion.

Pros
  • No scar in the breasts
  • Very little breast tissue is disturbed
  • Incisions are away from the placement of the implants which decreases your risk of infection
  • Breast augmentation scars are invisible
Cons
  • Blind, blunt pocket creation
  • Not applicable for silicone gel implants
  • Precise creation of pocket is difficult
  • Control of bleeding is difficult
  • Implant positioning is challenging
  • Difficult procedure
  • Few surgeons perform this

Findings: This surgery is quite challenging to perform as it lacks visibility and is performed away from the breasts. The challenging part is that only a few perform this and you have to make sure that the surgeon you pick is expert in this technique.


Conclusion

Yes, you have a number of options when it comes to breast augmentation incision. Each of them comes with its own set of advantages and disadvantages. So, consider your priorities in the future. For instance, if you want to have kids and breastfeed in the future, then incision in the nipple is risky as it may affect your breastfeeding success.

📌So, before the procedure, you have to tell the surgeon what you want and what your expectations are so you can agree on the best incision for you. Also, always consider your surgeon’s expertise because that is another important factor.

For those who already got a breast augmentation, what’s your preferred incision? Feel free to share your experience to help other women who are struggling decide.

Sources: 

Incision Options for Breast Augmentation

http://premierokc.com/breast-augmentation-incisions-okc/

What Are My Breast Augmentation Incision Options?

http://edenknowsimplants.com/choosing-an-areola-incision-with-your-breast-augmentation/

http://www.drconnall.com/Breast/Augmentation/Choosing-A-Breast-Incision.aspx

https://www.realself.com/question/breast-augmentation-incision-sites

Other Resources:

Breast Enhancement Herbs, Best Electrical Breast Pump, Breast Reduction Cream, Early Signs of Breast Cancer

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