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Transaxillary vs. Periareolar Breast Augmentation

Me and my husband are arguing about haveing the transaxillary incision. I'd rather do the Periareolar one. Which is best?

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28 Doctor Answers | Asked by anon

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My wife and I disagree on the incision!!??

You are not having the surgery. it is not on your body and you are crazy to do anything other than support her decision. if there is a sound medical reason to do one incision over the other then it is between your wife and her surgeon. so sit in the corner and nod.

Compromise - use the Inframammary Incision!

This is compromise at it's best: neither of you get your first choice, but your wife ends up with a great - arguably the greatest incision. Most patients and plastic surgeons sophomorically focus on the location of the scar as the most important issue in deciding on the incision. In fact, the scar is the least important distinction between the incisions. Why? Because any of three locations almost always gives a good scar. When it doesn't, it is usually related to patient biology, such that... more

Transaxillary vs periareolar vs crease breast augmentation incisions

The transaxillary incision is much less commonly used than it was several years ago. I have treated several patients from my area with misplaced implants through the armpit and even two whose doctors burned through the skin in the lower inner corner of the breast getting lost in where they were in the pocket dissection. Some revisions cannot be done through the armpit so another incision is needed. Finally, the numbness in the upper inner arm that can occur has made this less popular. The... more

Choosing the "best" incision for your breast augmentation

Choosing the best incision for breast augmentation There are basically four choices of incision for placing breast implants - Inframammary, per-areaolar, transaxillary and trans-umbilical. Choosing the incision for placement of the implants which is best in any given situation can be affected by many factors – these can be broken down into patient specific factors and surgeon specific factors. Patient specific factors include ethnicity and tendency for poor... more

Incision concerns

You are in a sticky place my friend...it is her body and she obviously has her reasons for wanting that incision--but I am sure that you have done a fair amount of research yourself. I would recommend meeting with your surgeon again and reviewing the pros and cons of each incision and also ask if your surgeon has a preference based on her anatomy. If you want to take it one step further, you may ask your surgeon if this patient was his spouse (this will only work if your surgeon is a male, by more

Difficult time selecting breast implant augmentation surgery incisions

You should both meet with the plastic surgeon to understand the risks alternatives and benefits of each of the incisions and be aware that the surgeon is capable of performing any or all of these incisions.

Otto Joseph Placik, MD

32 reviews

Chicago Plastic Surgeon

Incision for breast augmentation

There are advantages and disadvantages to each of the incisions used for access for placement of breast implants. In my experience, the vast majority of patients who choose the axillary incision are left with virtually no scar at all once it is healed; in other words, it looks like the crease that is anatomically there under the arm- and no visible scar. In an experienced surgeons hands, this access incision should yield the same results as any other access incision. Bottom line: when the... more

Best incision for breast augmentation

There are many great answers and I agree with most of them. Each plastic surgeon has their own philosophy. My best advice is to let your wife and her plastic surgeon decide. This is a big decision and she must consider not only the positives, but also the negatives. The only advantage to the transaxillary incision is that you don't have a scar on the breast. There are, however, many negative to this approach: (1) a scar in the axilla can be seen when raising the arms, (2) if the scar... more

Best incision for a breast augmentation

Ultimately, the choice of incision is up to your wife, with the guidance of her surgeon. Each patient's anatomy is different, and there is no perfect incision in each and every patient. In terms of popularity, national surveys have shown that the under the breast incision is by far the most popular. It also allows access in the future for any possible implant change, or removal. The second most common (and it's a distant 2nd) is the peri-areolar incision. The trans-axillary (armpit)... more

Best Incision for Breast Augmentation

There are 3 typically used incisions for breast augmentation, the transaxillary, periariolar and inframammary. Here is the truth about each. First, the transaxillary incision moves the incision from the breast to the armpit. It is technically more difficult to create the pocket and leaves a visible scar if the patient raises her arms wearing a sleeveless shirt or dress. The advantages are... Okay, I don't see any. Especially in darker skinned women where the scar will end up darker than th more

Incision choice for breast augmentation

There are 4 locations where an incision can be placed for breast implant surgery - under the breast in the fold, around the areola, in the armpit and the belly button. By far the most commonly used site is the one under the breast in the fold - the inframmamary fold incision - as it is formally known as. The reason for that is it is well hidden, has the most direct route for implant placement and pocket dissection. Also, if you do have future surgery, such as for implant rupture or... more

Which incision is best for breast augmentation surgery

There are several incisions which can be used for breast augmentation and each has its advantages and disadvantages. Although a transaxilarry incision is championed by many due to the scar being well hidden, it does have its limitations. It is difficult placing a larger silicone breast implant through this incison and a separate incision is often necessary if an implant or capsule needs to be removed or a revision performed. If a lift is needed, this cannot be performed through a... more

Mancy choices for incision for breast augmentation

The common choices are 1. inframammary, 2. Peri-areolar, 3. trans-axillary, and 4. trans-umbilical. I will use the first three, but not number 4, for too many reasons to list here. There are pros and cons to each and the patient should have the final choice in my opinion. In a nutshell, #1 gives the surgeon the most control and is the most common approach. Generally heals very well and scar quality will rival the periareolar scar in time. #2 scar looks better sooner, but potential risks... more

Incision location for breast augmentation

I think the best incision for breast augmentation that will give you the least complications is the inframammary incision (under the breast) - period. You don't see it and it heals without any problems. The periareolar incision is visible in some patients, in others it can leave a white noticable line that is distinct from the areola, it has a higher incidence of nipple sensitivity changes after surgery, and it absolutely has a higher incidence of capsular contraction than the inframammary... more

The best incision for Breast Augmentation

There are many options for breast augmentation. What type implant is she interested in? If she has chosen a silicone implan,t I agree with others that she may be better off with an inframammary crease incision. I personally prefer this incision and the majority of augmentations that I perform are through this incision. The crease incision affords great visibility and few complications. Hope this helps. Good luck.

No single best incision for breast augmentation in all cases

First, a few misconceptions about various factors influencing the choice of incision. One is nipple sensation; all recent studies show that the periareolar location does not have a higher incidence of sensory loss as compared to others, though many patients still seem to be told that. Another is capsular contracture, which should not be affected. In my view, you want the surgeon to have the most direct access without leaving an obvious scar. That way the space for the implant can be created... more

Incisions for Breast Augmentation

There have already been a lot of great answers here. The only thing I might add is that much of the scar quality depends on yourr wife's skin type and natural healing tendency. Scars placed around the nipple can be conspicuous if they don't heal well. Even a dark or raised scar will not be readily visible if it's in the axilla or under the breast.

Best incision for breast augmentation

In the end, the decision should be your wife's decision together with her doctor. Having said that, the transaxillary incision limits the size of a silicone implant that can be placed. Likewise any secondary surgery is more difficult through that incision. Just yesterday, I evacuated a ruptured silicone implant and did a partial removal of the capsule on a patient who originally had transaxillary incisions. We had to use a new incision (fold). As far as the choice of incisions, most... more

Periareolar breast augmentation incision

Each physician has their own way they prefer to do a procedure. I like the periareolar incision best because it allows you to easily position the implant and if you need a revision you can use the same incision. Although you can say the same for the infamammary incision, the periareolar is less visible and usually heals with a better scar. I don't like the axillary approach because, it implants can end up too high and you can't do revisions through it and it is very difficult to insert large... more

Periareolar or transaxillary breast augmentation incision

If you push your wife into a periareolar incision you may regret it for the rest of your married life. As you have read here, there are advantages and disadvantages to each incision type. The only thing that I have to disagree with is the statement that ALL future surgery performed in a transaxillary patient requires an additional incision somewhere else on the breast. This is simply not true. I have personally performed revisionary surgeries on patients with previous transaxillary incisions... more

I have no problem taking your side

While my colleagues might disagree...its much easier to do a capsullectomy or implant exchange through an inframammary or periareolar incision. I hope your wife never needs another procedure but, if she does, she'll end up with a second scar if she selects a transaxillary approach.

Breast augmentation incision

I am sure you will hear multiple opinions. Each surgeon has an approach that they have learned and feel most comfortable. You will need to decide where the scar is best for you. Every person has ideas as to where the scar will bother them the least. Future considerations are important as well as how you feel at this time. A lot of people like to avoid scar on the front of their breast where they will most likely see the scar. The periareolar scar generally heals very nicely but it is a... more

Marcus L. Peterson, MD

4 reviews

Saint George Plastic Surgeon

Breast augmentation incisions

There are a number of possible incisions that can be used for augmentation. I use only the periareolar and inframammary incisions for a number of good reasons. Both allow much better visualization of the area being opened and, thus, more accurate placement of the implant. The majority of misplaced implants I have seen are from other incisions, especially the axillary one. Also, I do not believe that anyone should attempt placement of anything other than a saline implant through these other... more

Transaxillary approach for breast augmentation has some issues

There are some issues with transaxillary approaches; the first of them being that you are limited in the size of silicone implant that can be placed through this approach. Any sized saline implant can be placed through a trans-ax incision, because the saline implant is placed when it is empty, and then filled inside the breast. The real problem with trans-ax incisions is the lack of control over muscle and infra-mammary fold dissection. Some surgeons do this approach 'blind' without the aid... more

Transaxillary breast augmentation produces excellent results

Transaxillary breast augmentation is a technique that places the scar off the breast, high in the underarm area. The result is excellent and the scar is away from view. The implant can be placed just as well with this approach as with any other. Transaxillary augmentation, or any breast augmentation for that matter takes skill and experience. There are surgeons who do not do the procedure well, or do not enjoy the procedure. Perhaps they feel it takes more time, though the benefit of the... more

Different incisions for breast augmentation

The transaxillary incision is the #3 choice on my list. My order of preference is 1 or 2 circumareolar or inframammary incisions. #3 transaxillary incision. I like the 1 or 2 not 3. Best of luck from Miami

The BEST Breast Augmentation Incision (Scar)

The fact that almost everything is feasible does not mean that everything SHOULD be done. With Breast Augmentation the implants can be placed through:- Periareolar approach - a short curved around the bottom of the nipple areola complex- Inframammary (bottom of breast) approach - a short incision in the under the breast fold- Transaxillary (arm pit) approach - - Trans Umbilical (TUBA) approach - - "Scar less" - Tummy Tuck Approach - a variant of the TUBA in which during a tummy... more