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Armpit Incision for Breast Augmentation Because Nipples Are Small?

asked 2 years ago by Kinzie in Illinois
Latest answer by Roy Kim, MD
Question viewed 64,340 times
Tags: silicone implant, armpit, incision, small nipples

What is recommended going through the armpit or the nipple for a 350cc silicone implant? I have very small nipples that are very round and on the darker side. please let me know the pros and cons.

The Dr. recommended the armpit because my nipples are small. I am concerned about the scar size on my armpit and I am worried that it will be visible. I don't want to have to worry about these scars showing in the summer time. please let me know your opinions. Photo attached.

36 answers to Armpit Incision for Breast Augmentation Because Nipples Are Small?

+7

Breast augmentation incisions

Hello, I think all three incision types are reasonable for you. There are three types of incisions that can be used to place a silicone implant for breast augmentation (TUBA, through belly button, can only be performed with saline) : 1) Inframammary: This incision is placed at the breast fold. It is easily concealed since it is at a natural crease plus it is convered by clothing including the brassiere and bikini top. This incision offers the surgeon... more
Remus Repta, MD

Phoenix Plastic Surgeon

www.aaaplasticsurgery.com

+4

Armpit incision very dependent on surgeon experience

You will have scars for the rest of your life whatever your choice of incision. You need to decide where you want your scars based on your favorite activities and clothing. You do not want armpit scars if your hobby is ballroom dancing. You may not wish prominent breast scars if you like going topless. I do a great number of transaxillary (armpit) breast augmentations and do not agree that the final shape is any different than an augmentation through a breast incision... more
Eric Pugash, MD

Vancouver Plastic Surgeon

www.vancouvercosmeticsurgery.ca

+4

Incision location for breast augmentation

With 350 cc implants, I would opt for an infra-mammary incision (within the crease of your breast). Every surgeon has his or her own preference, but placing such large silicone implants through the armpit and nipple can be quite challenging, and in some cases there is a risk of damaging the implant. If your surgeon has a lot of experience with the armpit incision, he or she should be able to show photos of other women's scars. This will allow you to choose the best approach for your... more
Nina S. Naidu, MD

New York Plastic Surgeon
+4

Breast augmentation incisions: the pros and cons

There are several different types of incisions for breast augmentation, and there are pros and cons to each. Each surgeon has their own preferences so it's important to understand that in general there is no absolute right or wrong answer. The armpit incision is used by some folks because it does not leave an incision on the breast mound itself-- this is the main advantage of this approach. However, there are some disadvantages, including 2 big ones in my opinion: one, the biggest risk... more
Shahram Salemy, MD

Seattle Plastic Surgeon
+2

Best Incision for Silicone Implants?

Really you forgot to mention the incision that will have the least problems in your case: inframammary. From your photo, you have developed inframammary folds. With silicone implants this gives the advantage of having the incision off the breast, gives direct visualization of the pocket, and typically heals well. The disadvantage of the inframammary incision is that sometimes the scar can migrate up or down if not placed correctly or closed correctly. The armpit incision for this size... more
Babak Dadvand, MD

Los Angeles Plastic Surgeon
+2

Incisions for silicone implants

The most common incisions for breast augmentation are under the breast (inframammary), through the areola (periareolar), tunneled from the belly button (transumbilical breast augmentation), and through the armpit (axillary). Of these, silicone implants cannot be placed through the belly button. In all of these procedures, there is a permanent scar. The least conspicuous is the belly button, but also limits your options. Because silicone implants are prefilled, they require a slightly... more
David Bogue, MD

Boca Raton Plastic Surgeon
+2

Incisions for silicone breast enhancement

Silicone implants require, per the manufacturers, an incision of approximately 5 cm in length.  Small areolas don't allow for an incision of this length.  Armpit incisions are okay but unfortunately symmetric incisions are a classic sign of surgery.  So you'll never be able to wear sleeveless tops. The inframammary incision is the only incision that hides better than the others and causes the lease amount of damage to the breast.  I make the incision 1cm below the fold... more
Christopher L. Hess, MD

Fairfax Plastic Surgeon

www.hessplasticsurgery.com

+1

Armpit Incision Has Advantages and Disadvantages Versus Other Approaches

Dea Kinzie- The armpit incision has a great advantage of not having any incision at all on your breasts. If you take great post-op care of your breasts after surgery, you should end up with a great result. The problem of having a small nipple is an issue with silicone breast implants, but use of a Keller Funnel should make a nipple, or areolar, incision possible to place 350 cc silicone breast implants. The disadvantage of the armpit... more
Roy Kim, MD

San Francisco Plastic Surgeon
+1

Breast implant incision sites

There are basically four incision sites for putting in breast implants. They each have their own pros and cons. Your doctor can explain each of them in greater detail, however, here is a brief summary: 1. Crease incision: This was the very first incision used for putting in breast implants. The advantage is that it is right at the lower border of the chest muscle so it is the easiest incision from the surgeon's standpoint for putting in implants either above... more
Edwin C. Pound, III, MD

Atlanta Plastic Surgeon
+1

Armpit incision vs Periareolar incision for silicone breast implant

I have used all incisional approaches to breast augmentation and in someone with your breast size I would probably be able to create a larger incision in your axilla than your areola - and that would allow easier/more predictable insertion of implants. Personally I would probably recommend an inframammary fold incision rather than a periareolar incision. There is no trauma to the breast tissue and ducts. There is less potential for infection and capsular contraction as well, in my... more
Jon F. Harrell, DO

Miami Plastic Surgeon
+1

Armpit incision for Silicone implants

As others have stated, there are 4 main incisions for placement of implants. Saline can be placed with any of the 4 incisions, but silicone (because it is pre-filled) does not easily fit through a small incision. The most common incision for silicone is inframmary (crease at the underside of the breast). Its safe, tested and gives the surgeon excellent visibility. Placed correctly, I have never had a patient complain about its location. It essentially hiden in most every type... more
Raj S. Ambay, MD

Tampa Plastic Surgeon
+1

Armpit incision for breast augmentation

Every surgeon has his or her preference in incision placement. From the looks of your picture you would be a great candidate for transaxillary breast augmentation (armpit incision) The axillary, or armpit, incision has the obvious advantage of not placing scars directly on the breast itself. With this incision, an endoscope (i.e. a retracting device with attached camera) is used to aid in visualization during the surgery. This incision placement is best for patients with small breasts... more
Jaime Perez MD

Tampa Plastic Surgeon
+1

Armpit incision for breast augmentation

There are several options for implant placement: inframmary, periareolar, armpit/axillary, and TUBA (incision around the belly button). No matter where you have the incision, you will have to have a scar. The inframmary incision and periareolar incision are two more common incisional placement by plastic surgeons. the armpit and TUBA are not commonly practiced. Not many plastic surgeon perform these incision. There are risks of complications regardless of where you place the incision.... more
Kim-Chi Vu, MD

Portland Plastic Surgeon
+1

Armpit incision not used as much any more as other approaches

Your areolae are not too small. You should know that they will expand about 1 cm in diameter after a breast augmentation. You could easily have implants inserted through a periareolar incision or inframammary incision. The transaxillary incision is less popular these days for several reasons. It can leave a troublesome scar that is visible when you raise your arm. Also, if you have repeat surgery (and most young women eventually do), a periareolar or... more
Eric Swanson MD

Leawood Plastic Surgeon
+1

Armpit incisions for breast augmentation

You may be a good candidate for this technique because of the small areola. The good news is that the scar is small and well hidden in the armpit. The bad news is that it often is difficult to position the implant into a proper postion behind the breast- it may ride up too high or be positioned too low. It is occasionally difficult to control this problem with this technique. It is possible to either go subpectoral or submammary with equal ease from this technique,... more
Francis (Frank) William Rieger, MD

Tampa Plastic Surgeon
+1

What is the best incision for my Breast Augmentation?

There are several different incisions that can be used for the placement of silicone implants. The "best" way is not the same for all patients, because it depends on multiple factors and is best discussed with your surgeon at the pre-surgical consultation. However, you left out one incision in your question that I believe would be the best for you: the inframammary or breast fold incision. I would not count this incision out for you because of... more
Erez Sternberg, MD

Jacksonville Plastic Surgeon
+1

Incision Placement

Every surgeon has his or her preference based on their experience and comfort level. I prefer placing my implant via an inframammary crease incision. I feel that that this route allows for excellent visualization of the pocket where the implant will go into, and is inconspicuous once healed. The breast usually hangs over the crease as the implant settles, thus hiding the incision.
Wilfred Brown, MD

Fairfield Plastic Surgeon
+1

I prefer the under the armpit incision

I have preferred the under the arm incision with endoscope for many years, but I was always limited to saline implants when doing this procedure through small incisions. Now for the last few years I have been using the Keller funnel and I can now place a 550cc gel implant through a 4cm armpit incision. There is excellent control of the implant placement and no scar on the chest, and a very inconspicuous scar in the armpit. See video see video
Rodney A. Green, MD

Cleveland Plastic Surgeon
+1

Incisions for silicone implants with small areola

It sounds like your plastic surgeon has determined that your areola are too small for the silicone implants to go through. This leaves the armpit or the infra-mammary fold, (IMF). There are pros and cons to each. Most plastic surgeons use the IMF in this case. Best to see a few board certified plastic surgeons. Bring photos of what you might want to look like. Please have reasonable expectations. When you get your consultations, you will have lots of... more
Jeffrey Roth, MD

Las Vegas Plastic Surgeon
+1

Incision site fro breast implants on women with small areola

Three incisional approaches are commonly used for breast implant insertion: trans-axillary (underarm area), peri-areolar (from about the 4 to 8 o'clock position of the areolas), and inframammary fold (in or just above the crease below the breasts). No two patients are alike, so it is important to individualize the surgical plan for each patient's individual needs. An advantage of the peri-areolar incision is that the color and skin texture difference between areolar skin and the... more
Michael Law, MD

Raleigh-Durham Plastic Surgeon

michaellawmd.com

+1

Best incision for breast augmentation -- small areola and gel implants

Another excellent option for you is to use saline through the peri areolar approach. Because saline implants start out empty ( as opposed to the pre-filled silicone implants), they can be placed through a tiny incision. In your photo, it seems that you could be an excellent candidate for the small incision in the areola. If a long scar is your primary concern, then saline may be a great choice for you. In my practice, saline implants through the... more
Michael Suzman, MD

New York Plastic Surgeon
+1

Incisions for Breast Augmentation

There are 3 incisions, inframammary fold, periareolar (in and around the nipple), and the axillary (armpit). All are acceptable, but they all have inherent advantages and disadvantages.   My preference (in greater than 90% of my patients) is to use inframammary fold incisions as it is hidden in the fold and it allows for optimal correction of any breast asymmetries as it is a more direct approach and it has less chance of nipple sensory loss (which is in the 5% range)... more
Rod J. Rohrich, MD

Dallas Plastic Surgeon
+1

Breast augmentation

I agree with the opinions of the others.  The inframmary incision would probably be the best approach (with the least risk) for you.
Shahin Javaheri, MD

San Francisco Plastic Surgeon
+1

Breast implant incision choices

For fairly large implants and fairly small areola, your two options are really through the inframammary fold or the armpit. A fairly large implant will put a 4-5 cms incision in the armpit which may be more noticeable than when a saline impalnt is used through that approach.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Best incision for Breast Augmentation

Hi there- I personally would not recommend the armpit incision to you- especially because of your concerns... With an incision under your breast, you can expect it to remain hidden from view unless you are hiding nothing from view.... Armpit scars are NOT invisible, and the fact that you will have one on each side of your body just makes them even more conspicuous and attention grabbing. Furthermore, I do not believe that most experienced and skilled surgeons would agree that the shape of the br more
Armando Soto, MD

Orlando Plastic Surgeon
+1

Armpit incision for breast implants has more complications.

Hi. With you anatomy, in New York City, we would do an incision in the fold under the breast for breast implants. This fold becomes much deeper after breast augmentation, and hides the scar. Safest and best results.
George J. Beraka, MD

Manhattan Plastic Surgeon
+1

Axillary or inframammary incision for small nipples

You have ONLY 2 options for incision, the axillary or the inframammary. Each has benefits and down side risks. Please become informed of these risks and try and make an intelligent decision. I personally would use the infra mammary. But that is me. From MIAMI
Darryl J. Blinski, MD

Miami Plastic Surgeon
+1

Incisions for silicone implants

Dear Kinzie, There are 4 main incisions use for breast augmentation: The fold below the breast (works for all implants and every patient) Areola (junction of the pigmented nipple with the breast skin) Axilla (armpit) Belly Button (TUBA) I personally perform the top 3, and consider the TUBA a non-controlled gimmicky technique. With silicone implants, you need a 4.5 to 5 cm long incision to avoid damaging the implant during insertion. Your areola look very small, so unless you extend the... more
Michael A. Bogdan, MD

Dallas Plastic Surgeon
+1

Breast implant incision choices

With the gel implants, the belly button is not an option.  The armpit requires a fairly long scar so how much better is this than the crease?  Not much really.  Your areolas are too small so these are out.  I'd personally recommend the crease for you. 
Richard P. Rand, MD, FACS

Seattle Plastic Surgeon
+1

With sub-muscular placement of breast implants, armpit is best incision

While the learning curve is high for placement of breast implants behind the muscle through the arm pit incision, I believe it is by far the best and safest incision. What really is done is you make a very small incision in the direction of the wrinkles of the armpit, you make a sub cutaneous dissection to the pectoralis muscle which is right there and then a blunt dissection behind the muscle. The implant never touches the breast tissue and therefore it is much less likely to get hard... more
Carl W. "Rick" Lentz III, MD

Daytona Beach Plastic Surgeon
+1

Know all options for incision for breast implant placement

The first thing you need to know is that there are 3 choices, not just the 2 that were offerred to you. The most common one is in the crease along the bottom of the breast, and if it is done right it should be very inconspicuous and certainly not visible in swimwear. The armpit (axillary) approach can leave a nice scar, but as you point out it will be visible and can be a tipoff that you have implants. The periareolar (not actually "through the nipple") is more popular than the... more
Richard Baxter, MD

Seattle Plastic Surgeon
+1

Incision placement for breast implants

You basically understand the pros and cons. One thing to understand is that the arm pit incision has the highest rate of implant malposition requiring revision, frequently via the inframammary incision. You may want to consider the inframammary incision.
Scott E. Kasden, MD

Dallas Plastic Surgeon
+1

Transaxillary (arm pit) breast implants for augmentation

The armpit scar is not invisible. It can be seen with your arms raised and it cannot be small due to the size of the implant. Typically it is a minimum of 2 inches in length.
Otto Joseph Placik, MD

Chicago Plastic Surgeon
+1

Incision for silicone implants via axilla/armpit

The transaxillary approach was originally popularized for Japanese women with exactly your situation. However, silicone gel implants require longer incisions than saline. Your surgeon should measure the proposed incision for each site to see if a gel implant can be placed and how long the scar would need to be. If you object to the axillary incision even though it might be the most appropriate, there are ways to lengthen the periareolar incision either by extending the ends at the 3 and 9... more
Robin T.W. Yuan, MD

Beverly Hills Plastic Surgeon
+1

An infra-mammary incision is best for larger silicone implants

From your photo, it would appear that you're a great candidate for an infra-mammary incision. When the scar is accurately placed, it will be concealed within the fold under your breast. This incision can be made long enough (about 4 cm) to accommodate a 350 cc silicone implant. Personally, I would have trouble getting a 350 cc implant through an axillary incision, but this does not mean it can't be done. I wouldn't recommend it to anyone. Every surgeon has a different philosophy on these... more
Scott Sattler, MD

Bellevue Plastic Surgeon
+1

The underarm breast augmentation

The under the arm, or trans-axillary augmentation is a very good choice to keep the scar off of the breast when the nipple is small, or there is no fold in which to hide a breast scar. I often use this approach for breast augmentation, and it can work well with both silicone gel and saline breast implants. The saline implant will fit through a small incision, about an inch, and the gel implant will often require an incision of 4cm, or an inch and three quarters if the implant is large. The... more
Peter E. Johnson, MD

Chicago Plastic Surgeon

www.peterejohnsonmd.com

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