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 (25)
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.
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.
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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.
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,
Web reference: http://www.bodysculpture.com
Breast Augmentation Scar Choices
Yes, you have a choice where your incisions are made. At Pacific Center for Plastic Surgery where I practice, I offer for Saline implants patients 4 choices: through the belly button (TUBA), armpit (axillary), beneath the breast (infra mammary fold) or around the areola (peri areolar).
You have the same choices for Silicone Implants except for the TUBA approach which is not possible.
Scars from breast augmentation
Regardless of the incision made to place breast implants, the incision site results in a scar. The main locations for breast implant scars include:
- Under the breast (inframammary)
- Around or within the areola (periareolar)
- In the armpit (axillary)
- In the belly button (TUBA - only available with saline implants)
The choice of incision is based on the size of implant, the type (saline or silicone), your own unique anatomy (size of areolas, etc.), and placement of implants (above or under the muscle).
When discussing breast augmentation with your plastic surgeon, you will be given pros and cons of each of these incision sites and which one they feel would work best for you. Your input as to where you would like incisions to be placed is very important. Be sure to ask to see examples of the final scars in each position prior to making your choice.
Web reference: http://www.drbogue.com
Choices for breast augmentation scars
Anywhere an incision is made, a scar will form. It is a natural part of the healing process. When it comes to breast augmentation, women have four choices for the incision site.
The most popular technique used at my office is through the areola. This is because: 1) the skin is thin and heals much quicker, 2) there is a natural border to hide the scar and 3) a special technique is utilized when placing the implant so less pressure is placed on the incision, allowing for a thinner more descrete scar. This incision technique is available for all saline patients, but may not be available for patients interested in silicone implants due to the size of the areola. This is because silicone implants come pre-filled and the areola may not provide enough space to allow the insertion of the implant.
The second most popular technique is through the arm pit (transaxillary breast augmentation). Patients like this technique because the incision is made in the armpit, which can be easily hidden in the natural fold of the arm.
The inframmamry fold (under the fold of the breast) is another option for breast augmentation, however, it is not recommended as much as through the areola or arm pit because the skin is thicker in this area of the breast which will leave a thicker, more noticable scar. The placement of this incision is also less descrete than that of the areola or armpit.
Much attention was given to breast augmentation through the belly button a few years ago because it was "scarless". However, Transumbilical Breast Augmentation (TUBA) has siginificant disadvantages and is not recommended. First, only saline patients are candidates for this procedure because the implant has to travel all the way up through the body. Because it must travel so far, more trauma is caused to the body which increasing bruising, swelling and recovery time. Complications are also more likely to arise because the surgeon uses a laparoscopic technique and cannot see as well as with other techniques. Untrained surgeons may also leave "track marks" down the abdomen when moving the implants through the body.
It is advised to utilize silicone based scar creams after surgery to help promote favorable healing. Your surgeon will most likely sell this at his office. It is also advised that you shield the incision site from the sun as much as possible.
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