A Patient Guide to Breast Augmentation
Lesson SIX:
Incision Options
Breast implant incision options.
The implant has to be placed through the skin somewhere — and the incision decides where the resulting scar sits and how the procedure is done. Here are the common approaches and the honest trade-offs of each.
Inframammary (breast fold)
a small incision hidden in the crease under the breast
The workhorse incision, tucked in the fold beneath the breast. It gives the most direct view and precise control when positioning the implant, works with implants of any type or size, and keeps the scar off the visible breast.
Advantages
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+Direct access and precise pocket control
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+Works with any implant, including larger silicone
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+Little effect on nipple sensation or breastfeeding
Trade-offs
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−Scar sits in the fold (usually well-hidden)
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−Can be visible lying down or arms overhead in some
Periareolar
along the lower edge of the areola, where skin color changes
The incision follows the border of the areola, so the scar blends where the darker and lighter skin meet. It offers good access and can be combined with a small lift, but it does pass near the milk ducts and nerves to the nipple.
Advantages
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+Scar blends at the areola border
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+Good access; pairs well with a minor lift
Trade-offs
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−Possible change in nipple sensation or breastfeeding
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−Limited by areola size for larger implants
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−Some data suggest slightly higher contracture risk
Transaxillary
a hidden incision in the armpit, using a camera (endoscope)
This approach places the implant through a small incision in the armpit, guided by a camera, so there is no scar on the breast at all. It's a nice option for the right patient, though it offers less direct control and revisions may need a different incision.
Advantages
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+No scar on the breast itself
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+Scar hidden in a natural armpit crease
Trade-offs
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−Scar can show in sleeveless tops and swimwear
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−Less direct control of the pocket
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−A revision often needs a different incision
Transumbilical (TUBA)
a rarely used approach through the belly button
A belly-button approach exists that leaves no mark on the breast or chest, but it works only with saline implants, gives the least direct control, and can't be used for most revisions — so it's uncommon today.
My approach — my preferred incision
In my practice, I much prefer the inframammary (breast-fold) incision for most patients. Tucked right in the crease under the breast, it hides very well — it stays out of sight even in a swimsuit or bikini, unlike an armpit (transaxillary) scar, which can show in swimwear and sleeveless tops.
It also carries less risk of changes in nipple sensation than a periareolar incision (around the areola), and it's less visible than a periareolar scar on the breast itself. On top of that, it gives me the most direct, precise control when positioning the implant, and it works with any implant type or size.
For the large majority of patients, the inframammary incision is the approach I recommend — but we'll always match it to your anatomy and goals.
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To schedule an appointment to discuss achieving your breast goals, please click here to contact us, click the below link to schedule online, or call us at (469) 899-8758.
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Through their website, you can access tools like the payment calculator and even find out if you qualify for a CareCredit card by starting a commitment free, instant application.