Many of my breast augmentation patients wonder about the placement of their incisions and whether different types of implants necessitate different incision points. Here are the three primary incision approaches and some thoughts on why each technique may best suit an individual patient’s needs.
A periareolar incision is made around the nipple right where the natural skin color darkens. The resulting scar is nicely camouflaged in this pigmented area of skin. This incision placement allows for the use of saline implants of nearly any volume or silicone implants of most sizes (often with the use of the Keller funnel).
Inframammary fold placement is another commonly used incision for breast augmentation. This approach has two distinct advantages. First, your surgeon has a great deal of access to the surgical pocket, which allows for more precision during surgery. Second, this incision point is also well-hidden, especially in women with fuller breasts that hang just slightly over the fold. This is one reason why the natural placement of your inframammary fold impacts your breast augmentation, although nearly any incision placement can deliver beautiful results in the right candidate.
Some women are attracted to the transaxillary or “armpit” approach because they like the idea of having no scars on their breasts. But the reality is that this approach has several downsides. The biggest concern is that, because the surgeon does not have direct access to the breast pocket, the implants can end up being poorly positioned after surgery. With proper care, the scars from a periareolar or inframammary incision should heal to be practically invisible, and both of these approaches give the surgeon direct access to the breast to create a flattering breast shape. In this light, there is really no reason to perform the transaxillary approach.