The incision placement for breast enlargements

Depending on what type of implant is used, the patient’s wishes and the surgeon’s preference the incision where the breast implant is inserted can be placed in one of the following places:

• The crease of the breast (inframammary)
• The lower part of the areola (periareolar)
• The crease of the armpit (transaxillary)
• The navel (TUBA, transumbilical)

The TUBA technique, transumbilical, is very uncommon among UK surgeons who generally prefer inframammary incisions.

Inframammary incision most common

The most used method is the incision placed in the breasts crease (submammary fold). Many suggest that this is the safest method since it provides a complete view over the surgical area, does not affect the mammary gland, can choose between placing the implant above or under the pectoral muscle as well as with modern technique place the incision precisely where the new submammary fold will be. This method is also suitable for the most common implants, cohesive implants with a textured surface.

Dissatisfaction with scaring is unusual

Many women worry about the scars being visible and aesthetically displeasing. But if the patient cares for the scars in the correct manner after surgery this is highly uncommon using the inframammary incision.

For further information about scaring visit the information page about surgery scaring » (coming soon).

Saline implants can decrease scaring

Some patients choose saline implants in order to minimise scaring after a breast enlargement. Saline implants can be filled once they have been inserted into the body which provides slightly more alternatives to choose from. However, the most used method is still placing it in the submammary fold, even with saline implants.

Areola incision placement (periareolar incision)

An incision to the lower part of the areola works well for many women but does risk more visibility since it is placed in an area of focus on the breast, which makes scaring easier to detect.

The areola incision also entails a greater risk of tactile variations of the nipple and difficulties breast feeding due to the breast enlargement. The incision is primarily suitable for subglandular (under the mammary gland but in front of the pectoral muscle) implant placement.

Armpit incision (transaxillary incision)

Placing the incision in the arm pit has an obvious advantage of the scar being hidden in the armpit, once healed it become almost invisible.

Some cosmetic surgeons imply that the technique can somewhat increase the risk of infection caused by bacteria in the armpits hair follicles. There are also those who think this method provides a lesser overview of the surgical area and that the implants tend to end up slightly higher up.

Practicians of the transaxillary incision method imply however that there is no increased risk of infection and the discussion surrounding the overwiew and the implants being placed high is due to unfamiliarty with this procedure, which according to them is just as safe as other incision methods

Navel incision (transumbical incision)

The principal advantage of a transumbilical incision is that it is hidden in the navel. The disadvantages are that implants inserted in this way can only be placed in front of the pectoral muscle, the surgeon may also have difficulties correcting any asymmetry and additional surgery cannot be performed in the same way, which would need to be done either with an areola or inframammary incision.

The method also limits the implant alternatives considerably since only saline implants can be inserted with this approach. It is therefore unusual for plastic surgeons to choose this method for breast enlargements.

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