Where Will I Have Scars After Breast Enhancement Surgery?

I want breast implants, but I don't want obvious scars.  Do I have a choice regarding where the incisions are made?

Doctor Answers (29)

Breast Implant Surgery Does Leave Scars but They are Well Hidden

+4

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.


Boston Plastic Surgeon
5.0 out of 5 stars 37 reviews

Scar location options for breast augmentation

+2
There are 3 options to consider for the location of the incision used to create the pocket for and place the breast implant. The final scar can hide within the lower fold of the breast (inframammary incision), along the outside border of the areola, (pigmented skin surrounding the nipple - periareolar incision), or within the armpit (axillary incision). While there are advantageous and disadvantageous to each technique, and I offer each of these 3 options, I tend to prefer the inframammary incision. Usually, this incision fades away into the crease between the lower portion of the breast and the chest wall. It affords the surgeon the most direct accessibility to the pocket being created for the implant which results in the shortest incisions and most symmetric and accurate implant placement. Unlike the periareolar incision, the inframammary incision avoids dissection through the breast tissue, which can result in contamination of the breast implant with bacteria normally found within the breast ducts.  The axillary scar has the disadvantage of potentially being noticable in normal sleeveless clothing.

Clay Forsberg, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 5 reviews

Incisions After Breast Enhancement Surgery

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There are multiple different options from the transaxillary, areolar, to the inframmamary fold. The most common incision is through the inframmamary fold as it allows you the best exposure for correction of any breast asymmetries and has the lowest incidence for loss of nipple sensation.

Rod J. Rohrich, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 20 reviews

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Implant scar options

+2

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.

Best Wishes.

Ricardo A. Meade, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 61 reviews

All incisions for breast augmentation are quite inconspicuous.

+2

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.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 51 reviews

The most common incision made nationally is the...

+2

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.

Gregory A. Buford, MD, FACS
Denver Plastic Surgeon
5.0 out of 5 stars 2 reviews

Scar placement choice

+1
Yes, you have a choice. You have one of three incision placement choices to make your scars less visible: transaxillary, periareolar or transumbilical. Transaxillary is in the armpit, periareolar is around the areola so it's hidden by the color and texture there, and transumbilical, which is through the belly button. All of these give you scars that are barely visible. Inframammary is in the breast fold, which could leave you with more noticeable scars.

Michael Constantin Gartner, DO
Paramus Plastic Surgeon
4.5 out of 5 stars 55 reviews

Incision Placement for Breast Implants

+1
Scarring depends on the incision placement. You can choose to have your implants placed through incisions made in the bottom fold of your breast (inframammary), in your armpit (transaxillary), or partially around your areola (periareolar). A less common incision placement is in your belly button. Each have their own merits.
 

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 74 reviews

Where will I have scars after breast enhancement surgery?

+1
Hello! Thank you for the question! The typical incision used for breast augmentation are: inframammary (in the fold beneath your breast), periareolar (at the border of the areola), axillary (within the armpit crease), and TUBA (through the umbilicus). Incision placement will do a lot with your preference, surgeon comfort level with that approach, and the type of implant - silicone implants will be difficult to place within certain access incisions. Breast augmentation scars are well concealed and are very discrete. They should not be visible within clothing, and likely hidden without clothing. If your concern is the visibility without garments, you should consider remote access incisions such as in the armpit. However, these other incisions heal very well on the breast and often times inconspicuous.

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!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 12 reviews

Armpit Incision Best for Breast Augmentation

+1
Your question is a good one and one that I deal with daily in my practice.  While you certainly have a choice of where you want the incision made for your breast augmentation, there are always better choices and not so better choices.  If I were you, I would like to hear the surgeon's preference as opposed to a politically correct answer.  So here goes.  I have been putting breast implants in through the armpit since the early 1990's.  This incision heals best of all choices because it follows what is known as Langer's Lines which none of the other incisions do.  This leads to often an invisible or almost invisible scar.  Also, no one, not even your mother, has intentionally looked in your armpit.  Incisions under the breast or around the areolar leave a visible scar, even in the best of circumstances which can cause embarrassment in the future.  The belly button incision most Board Certified plastic surgeons believe is a bad joke, and at best, one can only put in saline implants which in my opinion are far inferior to today's silicone implant choices. 
 
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. 

S. Larry Schlesinger, MD, FACS
Honolulu Plastic Surgeon
5.0 out of 5 stars 231 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.