Breast Augmentation: Q&A
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Armpit Incision for Breast Augmentation Because Nipples Are Small?
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.
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61 Doctor Answers |
Asked by
Kinzie
in Illinois
+5
Breast Implant Incision Under Breast Best for Silicone Gel Implants
Thank you for your question.
As you can see from the posted answers opinions vary greatly.
The most important issue is choosing an experienced, Board Certified Plastic Surgeon who does a lot of Breast Augmentation and follow his/her advice.
Generally, Silicone Implants require a larger incision which is easlily accomplished through an Infra-mammary Incison underneath the breast in the Infra-mammary Fold.
In my experience, the need for pocket revision or a secondary procedure...
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+5
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...
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+4
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
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+3
Incision options with small areola
Hi Kinzie,
There are several things to consider when deciding on which incision you use to perform your surgery. Cosmesis and the resulting scar are certainly an important consideration. Another consideration is the risk for capsular contracture. When a foreign body is placed in the body, the body reacts by forming a capsule of tissue around the foreign body. In the case of breast implants, this capsule can be soft or it can become hard and even painful...
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+3
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...
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+3
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...
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+3
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...
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+2
Breast Implant Incisions
Breast implants are placed into the pocket behind the breast through a variety of incisions. Some approaches, like those in the bellybutton or axilla (under the arm) are felt to be somewhat more problematic and less precise by many plastic surgeons. These approaches have more concerns with respect to poor positioning of the implant- these incisions are very remote from the area where the breast implant pocket needs to be meticulously created, and less visualization through these...
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+2
Incision Options for Breast Augmentation
You have many options when considering the incision location for your breast augmentation surgery. Aside from axillary or periaerolar incisions, you should also seriously consider an inframammary incision. This incision will be well concealed within the creases beneath your breast, and also has many added benefits as compared to your other options. Because the location of the incision is much closer to where your surgeon will create the pocket for your implants, the direct access can give...
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+2
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....
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+2
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...
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+2
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...
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+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...
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+2
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...
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+1
Silicone Implants and Incision Required
As others have mentioned there are four incisions that are used to place a breast implant. The periareolar and inframammary are the two most popular and the TUBA (trans-umbilical) Trans-axillary (arm pit) are the not some common ways. There are many good reasons why most plastic surgeons don't recommend the arm pit and the belly button incisions. The periareolar and inframammary are great incisions because they allow direct visualization of the pocket to be created and...
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+1
Armpit incision is not optimal for implants
For a number of reasons I tend to steer clear of transaxillary, or armpit, incisions. Aside from the fact that the rates of malposition and capsule contracture are higher with these procedures than inframammary approaches, they leave a visible scar more times than we would like to admit. And if you are using silicone gel, that scar will be longer still because the implant cannot be inserted in a deflated state like saline implants can. Lastly, if you ever need a revisional...
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+1
Type of Incision for Breast Augmentation
Dear Kinzie - More people are going to see your underarm than your breast. By far in my opinion the incision under the breast is the best for breast augmentation and unless you are going topless, they won't show in the summertime. After a year its hard for me to find them in most patients.
+1
Choosing an incision approach for silicone breast augmentation.
More than 95% of my patients select a silicone implant for their breast augmentation. In general, I perform half of these via a periareolar approach and the other half via an inframammary fold incision. In general, I prefer not to place a silicone implant via the axillary (armpit) approach unless i am using a saline implant or a very low profile silicone implant. However, I prefer to use moderate-plus, high profile, or extra high profile implants for most of my patients and...
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+1
Armpit incision is an excellent choice if your surgeon knows 9and has experience) how to do it
This is my procedure of choice for both saline and silicone implant for the last 15 years. After performing thousands of these operations i feel confident that this is THE BEST choice for most women. It is however technically challenging procedure and most surgeons are not comfortable performing it and therefore direct patients towards other options
see video
+1
An Inframammary Approach is a Great Option for Patients with Small Areolas
In a woman with small areola, a periareolar incision may not be acceptable for silicone breast augmentation. Under these circumstances, other alternatives should be considered for this procedure.
There are currently three incisions used for silicone breast augmentation surgery. These include the periareolar, transaxillary, and inframammary approaches. All three of these incisions have advantages and disadvantages when used for this procedure.
When choosing an incision, most women’s...
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+1
Best Incision for Breast Augmentation
Thanks for posting the question. In experienced hands only do I think the axillary approach is a good option, but there are limitations to this approach as with any approach. The inframammary scar is a great option for those whose areolar size will not accommodate a nipple incision. If you do the axillary approach, make sure your surgeon has performed a large number of these procedures to master the various nuances associated with it. Best wishes!
+1
Armpit incision for breast augmentation
Thank you for the question and your photo! I hope that these answers will assist you in your decision. As you know, there are several factors to consider for breast augmentation - implant type, incision location, placement of the implant, and size/projection of the implant.
You have valid concerns regarding your breast augmentation. I find that it is difficult to place that size of a silicone implant, or larger, through an axillary (armpit) incision. Also,...
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+1
Armpit incisions for breast augmentation
Incision options for a silicone implant are 3: armpit, areola and below the breast (inframammary). The size of the incision is really dictated by the size of the implant. The larger the implant, the larger the incision. For the smallest possible incision, a saline implant is needed. To get a larger silicone implant through the armpit, a lengthy incision will be needed (4-5cm) and will be more noticeable. For the most hidden incision with nearly all...
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Salt Lake City Plastic Surgeon
+1
Armpit incision
While I do agree that the size of your areoles are smaller it would not be impossible to go thought that area. It would just be a little more difficult. You definitely can see armpit incisions in certain positions. An infra mammary incision is the easiest and usually heals well enough that it should not be an issue. Perhaps a second evaluation by a plastic surgeon would be helpful.
+1
Either incision will work
From the pictures submitted it appears that your candidate for both breast augmentation through the transaxillary or periareolar approach. 350 cc is a modest-sized implant and can fit through a 4-1/2 cm incision either periareolar or through and armpit, especially if he uses a funnel. I would not personally recommend an inframammary fold incision since you do not have a lot of breast tissue and this incision would be highly visible. You're not getting enough volume were it...
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+1
Armpit Incision for Breast Augmentation Because Nipples Are Small?
Armpit and nipple incision sites have been shown to have a higher rate of infection and capsular contracture. I prefer the inframammary or breast fold approach in most cases for this reason.
When it falls in the breast crease the scar hides well. It is not visible in a bikini and not very noticeable in the nude, especially after the scars fade.
Best wishes,
Michael Vennemeyer, MD
+1
Inframammary incision is best for breast augmentation
I don't recommend either one. The best incision is the inframammary (under the breast) incision. I utilize a 2.8 cm incision for silicone gel implants in this size and a well placed incision under the breast "hides in the shadow" of the breast and is not visible. This also allows your plastic surgeon the best and most precision anatomically to place your implant. Finally it is the "route" with the lowest rate of complications as well. I hope this helps!
+1
Best incision for Silicone implants
Thanks for your post and the picture. I will agree with many of the previous posts in that the other incision to consider is the inframammary incision. Axillary scars tend to heal well, but will be visible when you lift your arm up, wear sleeveless dresses, etc. In experienced hands, I believe that there will be no difference in appearance of your final breast augmentation whether the transaxillary or inframammary approach is used. The difference resides in the fact...
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+1
Transaxillary approach is OK for Silicone Gel implants
In breast augmentation surgery, the result depends on the experience of the surgeon. Many plastic surgeons will be critical of the transaxillary approach, because they prefer other approaches and certainly good results can be obtained from many different approaches. You should be relieved and encouraged that you are a good candidate for transaxillary placement and this procedure has the great advantage that there is no scar on the breast. The axillary scars are for the most part,...
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+1
Incision type for silicone breast augmentation
I agree that a periareolar (nipple) incision is not the best choice given your nipple size and choice of silicone implants. I would recommend an inframammary (under the breast) approach for you. I love silicone implants, but they require a larger incision because they go in already inflated. I like the under the breast incision because it allows for precise placement of the implant and the breast itself generally hides the scar.
+1
Incision Options for Silicone Implants and Small Nipple-Areolae
Hi Kinzie,
Excellent question. Placing silicone implants through the armpit incision is a very reasonable option for your situation. If you prefer, the implants can also be placed through the nipple-areola incision even though yours are not very large. Based on your photo, the implants can be placed through a very small nipple-areola incision with or without the assistance of a device known as the Keller Funnel.
I use the Keller-Funnel (which is a...
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+1
Incision placement for breast augmentation
It is possible to place a 350 cc silicone implant through a peri-areolar incision that is about 3.5 cm in length. I would guess that despite having small areola, you could still use the peri-areolar approach because the lower arc of your areola is still 3.5 cm long. This approach is nice for hiding a scar in most patients. The axillary approach is also a possibility for you, but you would need to find a board certified surgeon comfortable placing gel implants through the axillae. I...
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+1
Best incision for Silicone Implants
When considering Silicone implants the inframammary fold incision should be the usual approach. This location is hidden well after healing and its size prevents micro- fracturing and weakening of the silicone shell which holds the implant material. However, if the patient has a large Nipple-Areolar complex then one can insert a Silicone implant through a periareolar incision without causing damage to the implant shell.
+1
Types Of Incisions Used For Breast Augmentation
Dear Kinzie,
With a board certified surgeon of extensive experience and outstanding reputation, you could qualify for any of the following three types of incisions to have breast augmentation with Silicone implants:
Peri-areolar where the incision is made around the areola of about couple of cm in a curved shaped following the perimeter of the areola. The nature of the color difference between the breast skin and the areola makes this type of incision less detectable....
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+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...
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+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...
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+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...
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+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...
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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...
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+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,...
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+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...
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+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.
+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
+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...
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+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...
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+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...
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+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)...
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+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.
+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.
+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.
+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
+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...
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+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.
+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...
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+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...
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+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.
+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.
+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...
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+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...
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+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...
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+1
Underarm versus nipple or inframammary incisions
Always go underam when you can. Underarm incisions become virtually invisible because they lie exactly on a crease that you already have in your underarm (look in the mirror and half fold your arm down until you see a clear crease form - this is the spot your surgeon will choose - he/she should have already made this clear). Scars on creases heal the best - these are universally better than a scar on your breast. The areola is a very risky place to place a scar, because...
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