Can I Get Silicone Implants Placed Under the Muscle Via Areola Incision?

I am considering getting implants next month. I want my implants to look as natural as possible. I am currently a 34 small B cup. I have a good amount of adipose breast tissue and my breasts are not droopy or saggy. I do not want the incision under the breast fold. I am considering getting the high profile smooth implants.

Doctor Answers 18

Breast Augmentation: Where is the Best Incision Placement?

The incision for breast augmentation can definitely be around the areola, which is the pigmented skin around the nipple.  Incisions are generally placed along the edge, particularly the bottom edge, running from the 3 o’clock position down through the 6 o’clock position and up to the 9 o’clock position.  Incisions can also be placed in the arm pit.  However, the most common incision is under the breast fold.  The incision under the breast fold gives the best and easiest access to the implant pocket and in the event of complications, is the best and easiest access to go back in for revision.  In addition, the peri areolae incision, the incisions around the areolae, has to go through the muscle and may pre-dispose to scar attachment between the muscle and the overlying breast, giving rise to a condition called animation, where when the muscles contract, the breast also moves.  This can be very difficult to cure and very disappointing for patients.  This is highly unlikely if you go in under the breast.  So, good luck and choose carefully. 

Englewood Plastic Surgeon
4.9 out of 5 stars 24 reviews

Areola incision for submuscular implants

Yes, the areolar incision can be used for breast augmentation and still have the implants placed beneath the muscle. The size of the areola determines if this can be done. The circumference of the lower half of the areola (distance around the lower border) should probably be at least 6 cms for a modest high profile implant.

Ronald Schuster, MD
Baltimore Plastic Surgeon
4.9 out of 5 stars 77 reviews

Silicone Implants through a Peri-Areolar Incision

The short answer is, yes. Silicone implants can be placed under the muscle through a peri-areolar (around the areola) incision, provided the areola are large enough. If not, another incision choice should be used such as underneath the breast (infra mammary). 

Asaad H. Samra, MD
New Jersey Plastic Surgeon
5.0 out of 5 stars 40 reviews

Silicone implants

Silicone implants can certainly be placed trough an areolar incision.  However, it becomes more difficult if your areolae are small, in which case your surgeon may advise the inframammary Incision instead.  And that's okay, because the inframammary incision heals quite nicely.  I use it frequently, with almost no complaints.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 27 reviews

Periareolar incision

You absolutely can have silicone implants placed through the areolar incision.  There are three acceptable incisions for placing silicone implants.  The transaxillary, the periareolar, and the inframammary.  In my opinion, the least favorable one is the transaxillary approach.  Firstly, all surgeons if they operate, have some patients that require revisions.  It is usually impossible to perform revisions through the transaxillary approach.  These patients now  require a second incision.  Also, some breast augmentation patients require a particular surgery in order to optimize the result called a dual plane dissection.  This, too, is not possible through the axillary approach. Lastly, in the transaxillary approach, the surgeon has no tactile input to develop an optimal breast pocket. The surgeon relies purely on long instruments and a camera.  The surgeon gets no feed back from his fingertips, a most sensitive tool.  For some surgeons to claim that the transaxillary approach is" the best" is misleading and a bit arrogant.

Ary Krau, MD, FACS
Miami Plastic Surgeon
4.8 out of 5 stars 319 reviews

Silicone implants through areola incision

The ability to use the areola incison depends upon the size of your areola and the size of the silicone implants. This was my preferred method of access when I did saline implants.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Peri areolar incisions can be used for either under the breast or under the muscle or dual plane or subfascial

The answer is that the implant can be put any where through the peri areolar incision and the results are great. I feel that if you are going under the muscle the trans axillary (arm pit) is best. Best scar and fewest problem. If you have a good deal of breast tissue in the upper pole of your breast to cover the possible ripples from the implant and you want the most natural looking and feeling breast, I would recommend the peri areolar sub  mammary (under the breast) with textured silicone gel implants. 

Carl W. "Rick" Lentz III, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 15 reviews


Hi AZLatina,

The short answer is yes.  This is a common approach used for breast augmentation either placement on top or under the muscle works well.  There has been some recent data that feels there may be a slighter higher capsular contracture rate with this approach.  It has been shown that the bacterial contamination from the ducts and nipple is higher increasing the Biofilm risk.  Personally I have not seen a higher contracture rate with an areolar approach.

Todd B. Koch, MD
Buffalo Plastic Surgeon
4.7 out of 5 stars 35 reviews

Periareolar Incision for Silicone Gel Breast Augmentation


To restate what the other surgeons have said, it is commonly done, and more than likely you would be able to have it performed that way.  Some individuals have a large enough areola that allow easy access via this route.  Those that don't may be better served with either an inframammary incision or an armpit incision.  On the other hand, certain individual with poorly defined inframammary folds might do better with the periareolar or armpit incisions.

From a complication standpoint, the lowest risk incision (specifically capsular contracture, the most common complication) is the inframammary incision.  This is because there is minimal breast tissue or milk ducts that are violated, minimizing bacterial contamination that typically causes capsular contracture.

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 89 reviews

Periareolar augmentation for submuscular implant placement

Thank you for your question. This is my preferred aproach to submuscular breast augmentation. I go through the areola down to the muscle and than I dissect laterally to pick up the muscle edge. I do not divide the muscle as some surgeons do, but incise the fascia to enter the sub muscular plane. You state that you want to look natural and have good amount of adipose tissue. If that is the case, I prefer to place the implants under the subfascial muscle plane (the tough tissue covering the muscle) instead of submuscular placement. With submuscular placement you will have some degree of breast distortion with muscle flexing. Good luck.

George Marosan, MD
Bellevue Plastic Surgeon
4.8 out of 5 stars 38 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.