As you look forward to your breast augmentation, there are many things to be excited about, like a fuller chest, better cleavage and an easier time shopping for clothes. But you might also be thinking about certain downsides — namely, the scars the surgery leaves behind.
However, not all breast augmentation incisions are created equal.
Breast Augmentation Incision Options
Breast augmentation incisions have changed a lot since the procedure first became mainstream. While scars were once large and partially visible in bras and bikinis, experienced and qualified cosmetic surgeons no longer utilize such methods. There are four incisions commonly used in modern breast augmentation, each of which is designed to be minimally visible.
Inframammary
With this approach, a short incision is made in the breast crease, also called the inframammary fold. This does leave a 1- to 2-inch scar behind, but it is small and easy to hide. The inframammary incision also facilitates use of larger silicone implants or gummy bear implants, which can be difficult to insert through other incision types.
Transaxillary
This method places a small incision within the armpit, allowing it to be hidden away in most circumstances. Your cosmetic surgeon then uses a special camera and instruments to ensure proper placement of the implant.
Transumbilical
Using this approach, a small incision is made just above the belly button. The implants are inserted through this incision, and then pushed up to the breast pocket. While this leaves no scar on the breast itself, it does leave a small one on the abdomen.
Periareolar
With this method, the incision is made around the outer edge of the areola, creating a semi-circle shape. The scar itself will blend into the natural pigmentation and texture of the areola, allowing it to essentially be hidden in plain sight. It also allows for a breast lift to be done at the same time as an augmentation.
The periareolar incision can be made on any part of the areola edge, but is most often made on the bottom half, as this tends to best disguise scarring. Through this incision, a pocket is created, which may be within the glandular tissue or underneath the muscle.
The insertion method may vary, but a funnel is often used. The tip is inserted into the pocket, allowing the implant to roll through it and into the pocket. Once the implant is in place, the funnel is removed and the implant is centered. If the implant is saline, it is easily inserted and then filled and centered. The incision is then closed and the process is repeated on the other breast.
Which incision is best will depend on your anatomy and goals for your breast enhancement. However, many cosmetic surgeons prefer the periareolar above all options.
3 Big Benefits of the Periareolar Incision
There are many periareolar incision pros, but there are three in particular that stand out:
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The Ability to Camouflage the Scar
Scars tend to be raised and textured, as well as darker than the skin that surrounds them. All of this contributes to their visibility. However, the areola itself is raised, textured and darker than the skin that surrounds it. As a result, scars tend to blend right in once the redness fades a bit. In many cases, even women who have this type of incision struggle to find the scar.
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Greater Control over Placement
With this approach, the incision is precisely where the implant will be placed. Unlike incisions that require the implant to travel through the body to the location, this incision offers significant ease in placing the implant correctly and in controlling bleeding and other potential complications.
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The Opportunity to Reuse the Incision Site
With other incisions, they cannot easily be reused for future breast surgeries, whether augmentations or otherwise. However, the periareolar incision can be used more than once. This means less scarring to worry about.
The Potential Drawbacks of the Periareolar Incision
While these benefits are big, there are downsides to consider as well. Perhaps the most notable is that the scar may not heal as expected and instead end up lighter or more raised than the areola, making it easier to see or even visible through a bra or swimsuit. There is also the fact that you may need to wear different bras for a while until you are more comfortable. This incision type is also is more likely to cause issues with milk ducts and nerves in the breasts, which may interfere with breastfeeding.
Choosing a Breast Augmentation Incision Type
Ultimately, you may find yourself leaning more towards certain incision types than others. Carefully consider the recommendations of your cosmetic surgeon when deciding which breast implant incision method could be best for you. Keep in mind that your physical anatomy, preferred implant type and other factors play a role in determining the best decision for your breast augmentation. While the periareolar approach is excellent, it may or may not be right for you.
Author: Dr. Joseph Castellano
Dr. Joseph Castellano is a native Floridian who grew up in the Tampa Bay area. After medical school and residency, Dr. Castellano returned home and has opened a practice in Tampa, Florida focusing on breast augmentation, abdominoplasty, liposuction, facelift, and eyelid rejuvenation. He is a member of the American Board of Cosmetic Surgery, American College of Surgeons, and American Medical Association
