I want breast implants, but I don't want obvious scars. Do I have a choice regarding where the incisions are made?
Where Will I Have Scars After Breast Enhancement Surgery?
Doctor Answers (28)
Breast Implant Surgery Does Leave Scars but They are Well Hidden
The common techniques used to place Breast Implants are well hidden following surgery. Most are hidden under the breast. Incisions can also be placed in the Axilla or arm pit. Even Implants placed through the Areola are often well concealed. See photo in link below.
There are many tips for improving Breast Implant Scars which can improve your result.
Scar location options for breast augmentation
Incisions After Breast Enhancement Surgery
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Implant scar options
If you do this, the implant has to be placed somewhere .. and no, the belly button is not a good choice. The options are the armpit, the areola and the fold under the breast. They all feel the same after surgery. The armpit one leaves your breast without scars but it requires the lower pole (bottom) of your breast to not need any work.
The areola leaves a scar that needs to be placed perfectly so it's not visible and you need areolae larger than 30mm in diameter. The fold scar is hidden in the fold under the breast and is used very frequently because it is easiest for conventional surgeons. It all depends on what your palstic surgeon is used to.
All incisions for breast augmentation are quite inconspicuous.
The 4 incisions for augmentation include the armpit, the belly button, the crease under the breast, and the bottom on the areola. The armpit and belly button are the least accurate in terms of making a perfectly symmetrical pocket for the implants because of their distance from the working area. The armpit also has been associated with numbness in the upper inner arm similar to what happens when breast cancer patients have lymph nodes removed.
Since most patients currently want silicone gel implants for their improved "feel" over the saline, the crease is the best approach followed by the areola as long as the diameter of the areola is sufficient.
As long as you don't need lifting scars, the scars from a simple augmentation should be worth the benefit regardless of their location as long as you have an excellent doctor doing the surgery.
The most common incision made nationally is the...
The most common incision made nationally is the Inframmary Crease Incision, which is placed just slightly above the breast fold.
Other incisions can be made:
- Around the areola (pigmented tissue surrounding the nipple)
- Beneath the arm (axillary approach)
While a few physicians promote implant placement through the belly button, most Board Certified Plastic Surgeons do not consider this to be a safe or necessary approach.
In my practice, I tend to use more cohesive silicone gel implants than saline implants. Because these are pre-filled, they require a slightly larger incision (2 inches vs. 1 inch) than their saline counterparts. Even with this larger incision, a majority of my patients feel that they achieve a more natural look and feel with the gel implants and rarely complain about the additional incision length.
Incision Placement for Breast Implants
1) INFRA-MAMMARY INCISIONThe infra-mammary incision is probably the most popular type. It is placed at or slightly above the crease under the breast. This is one of the most common incisions because it allows for the most direct access to the breast implant pocket, making accurate placement of the implants quite predictable. It also leaves the actual breast tissue completely undisturbed, minimizing any effects on breast-feeding and nipple sensation.
2) PERI-AREOLAR INCISIONThe peri-areolar incision is made along the lower border of the pigmented skin around the nipple (the areola). This second type of incision is commonly used in women with a poorly defined fold under the breast, as long as their nipple size is not too small. It is another popular incision and usually heals quite well, resulting in an almost "invisible" surgery scar.
3) TRANS-AXILLARY INCISIONThe third type of incision is placed high in the armpit and is called trans-axillary. The benefit of this incision is that it eliminates scars on the breast itself for "scarless breast augmentation". Women with poorly defined folds under the breast and small nipples make for a good candidate for this type of incision. Although a scar is avoided on the breast, it is important to remember that there will be a scar in the armpit. This may may become an issue when wearing certain sleeveless tops or bathing suits. A scope (endoscope) is often used to perform the breast augmentation procedure to improve predictability.
Where will I have scars after breast enhancement surgery?
It is common for scars to fully mature for up to a year. In the meantime, there are a few things that may help to ameliorate your incision/scar. The most proven (as well as cheapest) modality is simple scar massage. Applying pressure and massaging the well-healed scar has been shown to improve the appearance as it breaks up the scar tissue, hopefully producing the finest scar as possible. Other things that have been shown to add some benefit, albeit controversial, are silicone sheets, hydration, and topical steroids. In addition, avoidance of direct sunlight to the incision will significantly help the appearance as they tend to discolor with UV light during the healing process.
If unsightly scars are still present after approximately a year's time, other things that your surgeon may consider are intralesional steroid injections, laser, or just surgical revision of the scar itself.
Consult with a plastic surgeon your goals, concerns, and expectations. Certainly incisions should be considered, but should not limit your overall result by hindering visualization and access to your surgeon, and what produces the best results in his/her hands.
Hope that this helps! Best wishes!
Armpit Incision Best for Breast Augmentation
Incisions in the armpit can be very short, often not more than an 1-1/2" long, even using large implants if one uses the Keller funnel. This operating tool also allows the surgeon to not drag skin bacteria into the implant pocket, therefore decreasing the chance of hard breasts. I do all my armpit or axillary breast augmentations using an endoscope which allows much more control over potential bleeding and a more perfect pocket creation than when not using one.
I believe you have three reasonable choices: periareolar (around areolar), inframammary (the crease beneath the breast), and axillary (armpit). As you can tell, my preference would be the armpit. Good luck.
Breast Implants - Incisions
Nobody wants visible incisions and they are, in general, pretty well hidden. But dependin on the type of implants you have, the location of the incisions and specifics of your skin type, it is not realistic to expect them to be completely hidden. The most common incisions are periareolar (more specifically and accurately infra-areolar, since they are around the lower portion of the areola), infra-mammary (under the breast), axillary (armpit) and umbilical (belly-button). The last is available for saline implants only and the first two are the most commonly used.
The best thing is for you to try to decide which type of implants you want and then go visit a few different plastic surgeons to get some ideas of the options for you.
I hope that this helps and good luck,