5 Things You May Not Know about Breast Implant Incision Placement

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For many women, thinking about incision placement often falls lower on the priority list after considerations like implant size and debating between silicone gel or saline. Yet, in some ways, incision
placement can end up informing some of the other decisions surrounding your breast enlargement.

There are three basic options for incisions: periareolar (around the nipple), inframammary (below the
breast, hidden in the natural crease) and transaxillary (in the underarm). Which one is right for you?

Here are five things that just might influence your decision.

1. The Relationship with Implant Size
If your goal is to have silicone implants that are on the larger side, this may limit your incision options.
Silicone implants come prefilled from the manufacturer, and (according to manufacturer specifications)
require an incision of at least 5 cm. A periareolar incision may not support this length, so higher volume
silicone implants may necessitate insertion via the inframammary fold.

2. Potential Limitations on Implant Type

In close connection with the first point listed above, implant type also may be limited by incision. Saline
implants are inserted deflated and then filled in place, allowing for a relatively small incision. If you like
the idea of having no scars on your breasts following surgery and are considering a transaxillary incision,
most surgeons will only use saline implants with this incision method.

3. Not All Incisions Are Created Equal

There’s actually a fourth incision type that’s used less often: TUBA, or the placement of implants via
the belly button. While this option does not create a scar on the breasts, there are definite limitations.
Full access to the surgical pocket simply isn’t possible through this method, which can mean subpar
pocket creation that could compromise your long-term results. Although aesthetic complications may
addressed quite effectively by following a few tips for a beautiful breast surgery revision 
after the fact, obviously the preference should be for a surgery performed properly the first time.

4. The Possible Connection with Capsular Contracture

The excessive growth of scar tissue around the breast implant, known as capsular contracture, remains
one of the most troubling complications of breast implant surgery. Some research suggests that incision placement could affect
its development. Specifically, the periareolar incision’s proximity to the milk ducts could introduce certain bacteria into the surgical pocket, causing the body to over-produce scar tissue around the
implant as it battles the infection.

5. Experience Matters

While technical skill will greatly affect the results of any breast augmentation, this holds especially true
for transaxillary placement. The idea of transaxillary placement is tempting for many women, as this
approach keeps incisions hidden. However, since this surgery is performed endoscopically and requires
a trained eye to gauge proper placement, it’s absolutely essential to only choose a board certified plastic
surgeon with plenty of experience in this breast enlargement approach specifically.

Which Is Right for You?

So how do you know which incision placement is right for you? Your choice ultimately comes down to
a combination of priorities and practicality. For example, if your top priority is an endoscopic breast
enlargement, then accept that this may mean having to choose saline rather than silicone gel implants.
It’s smart to stay flexible about incision type and listen to your surgeon’s instincts on which placement
he or she feels will work best. As with every aspect of cosmetic surgery, incision placement is all about
finding the option that will create the most beautiful final results.





Article by
Beverly Hills Plastic Surgeon