African American w/Hyperpgimentation - Best Incision Site for Breast Augmentation?

As an African American, with (Hyperpigmentation) Wots the Best Incision Site for Breast Enlargement?

Doctor Answers (10)

Hyperpigmentation of Scars with Dark-Pigmented Skin


I recognize some prefer the periareolar approach, yet there is still the risk of hyperpigmentation and scar thickening with EVERY incision.

Consider preop and post-op use of "bleaching creams" (hydroquinone).  I treat my patients with hydroquinone cream twice daily for two weeks preop and resume hydroquinone at 4-6 weeks post-op to try to minimize the risk of hyperpigmentation.

Combining the above with scar therapy cream, post-op may be wise.

Denver Plastic Surgeon
4.0 out of 5 stars 5 reviews

Hyperpigmentatuion scars


The choice for implants can be through the armpit, along the border of the areola, and underneath the breast fold.  All may be problematic. You will have to follow closely with your plastic surgeon.

Manhattan Plastic Surgeon
4.5 out of 5 stars 14 reviews

Areolar incision for patients with scarring and pgimentation problems


With a higher likelihood of hypertrophic scarring or hyperpigmentation, I generally prefer the peri-areolar approach. Discuss the risks and benefits with your surgeon

Web reference:

Chicago Plastic Surgeon
5.0 out of 5 stars 39 reviews

Best breast augmentation procedure for patients that scar poorly.


The answer to this question is quite simple. The transaxillary approach (armpit incision) leaves a well hidden scar leaving no marks on the breast. When performed with an endoscope, by an experienced surgeon, this approach is superior to any other.

Now, with the use of the "Keller Funnel" I am able to insert gel implants through the armpit, giving my patients the best of both worlds. The nipple incision is obvious, and the incision in the fold of the breast might not be visible when you are upright , but  at some point one does recline, and the scar can be outright unsightly. I wrote a short article that can be found in my website, or in the research section of I hope this helps...

Miami Plastic Surgeon
5.0 out of 5 stars 30 reviews

Hyperpigmentation of Scars


Hi there-

As you can see, there are a great many opinions about this, and it should highlight to you that the placement of the incision is most often related to the individual surgeon's comfort with that approach...

Putting my own preferences aside (as much as I can), here's what makes most sense to me... 

Understanding that because of your skin type, you are at high risk of pigmenting your scar no matter where it is placed, where would it be easiest to hide if it does pigment? My opinion- under your breast....

If your scar pigments around your areola or under your arm, it will be obvious, especially as you would have one on each side... Whereas placing them under your breasts would allow them to stay hidden (even when you are not wearing any clothing) until they fade.

More importantly however, is understanding that there are definitely technical details that can minimize your risk of pigmenting your scars- find the best surgeon you can and discuss this with them. With minor modifications in technique, the risk can be lowered.

Web reference:

Orlando Plastic Surgeon
4.5 out of 5 stars 82 reviews

Breast Augmentation Incisions in People of Color


Dear Sarah,

First question is what injury or incisions have you had in the past that have produced unfavorable pigmentation. Hyperpigmentation is usually caused by inflammation or hormonal influences.  I would advise you to visit a board certified plastic surgeon to evaluate your previous scars.  If you have unfavorable healing by exam then I would recommend an axillary incision.  A transumbilical incision is possible (done plastic surgeons who have extensive experience via this incision) or a well placed crease incision in a well defined crease.  I probably would recommend saline implants because the incisions are much smaller for these implants.  Good Luck.

Dr. ES

Atlanta Plastic Surgeon
5.0 out of 5 stars 6 reviews

Breast Implants Incisions


The most common  breast implant incisions are under the breast or around the areola.  Either location is a good choice in the appropriate patient.  The issue of hyperpigmentation is real for patients with this tendency.  However, either incision location is still okay.  Special steps can be taken with creams and injections which can help minimize the chance of pigmentation changes.  Good luck.

Web reference:

New York Plastic Surgeon
5.0 out of 5 stars 52 reviews

Breast Augmentation incision.


I believe the inframmary incision is usually the easiest to conceal and will give the least number of problems.

If a problem develops it can easily be treated and covered up and usually with the breast tissue coming down after an augmentation it is partially covered. 

Arlington Plastic Surgeon
5.0 out of 5 stars 2 reviews

Periareolar Incision is Good for Augmentation


I feel that the periareolar incision is good for all cases and especially in patients prone to form hyperpigmented scars.  The reason is that there is already a color contrast here and therefore the incision tends to blend in better.  It can sometimes be difficult to place a silicone implant through a periareolar incision if the areola is quite small, but there is never a problem with a saline implant since it can be placed deflated and filled after it is in position.

Louisville Plastic Surgeon
5.0 out of 5 stars 2 reviews

African american, hiding the augmentation scar


For those who are prone to hyperpigmentation one of the best locations for incision in breast augmentation is the around the nipple or periareolar approach. The pigmentation can be concealed within the natural color of the areola and off of the chest or breast skin.

Best of luck,


Web reference:

Chicago Plastic Surgeon
4.0 out of 5 stars 25 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.

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