I am Asian, 5'4 130 lbs, 34A/B. Saline Implant with periareolar incision or Silicone Implant with inframammary incision?

I am asian 5'4" 130-135lbs 34A/32B and shooting for full C. I am having a BA in 10 days 3/19/14!!!!! At first I want to have the silicone implant with periareolar incision as it seems to heal nicely in asian women but the PS said that my areolas are too small for pre filled silicone even if it just 300cc. I decided to go with 350/375cc mod+ so if I want silicone implant I'll have to go with the inframammary incision instead of periareolar incision. I am so torn and so afraid of the keloid scars and afraid of the scars that could be too high or too low from the creases but I still want the natural look and feel. So confuse now please help! Thank you!!

Doctor Answers 9


I have helped many asian patients achieve beautiful results with the inframammary incision. The key is to follow post-operative instructions closely to minimize the risk of abnormal scarring. You can also do scar treatments, such as silicone sheeting and silicone gels, once the steristrips fall off. However, if you have a history of keloid scarring then you may want to reconsider getting the surgery altogether, as you can develop abnormal scarring even when the incision is periareolar.

Toronto Plastic Surgeon
5.0 out of 5 stars 179 reviews

Best Incision for Breast Augmentation - It depends...

For women that are slender with small breasts, I recommend a silicone implant. An exam and measurements would be required to give a specific opinion for you. Here is some helpful information: All breast augmentation incisions have their pros and cons. If you do not have a small areola then a periareolar approach is reasonable and the scar is more camouflaged. However you should be aware that there is a higher risk of capsular contracture and not being able to breast feed with this approach. A transaxillary approach also has a higher risk of capsular contracture and has no breast scars. An inframammary approach would probably be the safest with least risk of complications with the scar tucked beneath the breast to hide it. Hispanics/Asian/Mediterranean, and African American populations have more of a tendency for raised scars/keloids.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 157 reviews


Thank you for the question.

To best help you, a physical examination or picture evaluation is required in order to determine which procedure or technique would be best for your case.

Dr. Campos

Jaime Campos Leon, MD
Mexico Plastic Surgeon
4.4 out of 5 stars 253 reviews

Inframammary breast augmentation incision works fine in Asian women

Thank you for your question.  If you want the natural feel and other benefits of a silicon gel implant then you should have an inframammary crease incision.  The transaxillary incision can also hypertrophy and problems with implant position abnormalities requiring revision with an inframammary crease incision are not infrequent.

I routinely use the inframammary crease incision and Asian women and have had no problems with abnormal scar healing.

In addition if you do developed scar problems the new 1540 non-ablative fractional erbium laser can correct scar problems nicely.

Scar concern

You may consider a trans axillary or arm pit incision for saline or silicone implants. This is a specialized procedure done by a select few plastic surgeons with advanced training in this minimally advanced technique.
With over ten years of doing this procedure I feel it is an excellent procedure for many patients.

Gregory T. Lynam, MD
Richmond Plastic Surgeon
4.9 out of 5 stars 59 reviews

Implant and incision choices

Thank you for your question. For a slender woman with small breasts, the gel implant would be the better choice since they have a more natural feel. You could ask your surgeon about the Keller Funnel. This is an ingenious device that came on the market last year which allows us to insert gel implants through small incisions.

For another option, there may be a plastic surgeon in your area with endoscopic surgery expertise. There are many of us in the San Francisco area who use endoscopic techniques which allow us to do the operation under direct visualization thru a small incision in the axilla (armpit). Now that we have the Keller Funnel (thank you Dr. Keller) we can insert a gel implant thru this small axillary incision. I recently placed a 550cc implant using this approach. I too would be concerned about the possibility of a more noticeable scar in Asian skin, so I would encourage you to talk to your surgeon again before proceeding with surgery. 

William McClure, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 5 reviews

Incision and implants

I think that the incision placement really depends upon the size of implants going in, and the size or your areola.  If the areola are small, then you have to use a different incision.

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

Saline Implant with periareolar incision or Silicone Implant with inframammary incision?

I would recommend you go with the inframammary fold.  Silicone implants will feel more natural than saline.  Also, you can get a hypertrophic scar in a periareolar incision as well as an inramammary fold incision.  I personally prefer using the inframammary incision before you more control o the pocket during the dissection.

Rigo Mendoza, MD
Tampa Plastic Surgeon
4.4 out of 5 stars 39 reviews

Breast augmentation

I only use the inframammary fold.  It affords the most control.  There is a new product called Embrace so there are some new options.

In breast augmentation I have chosen to spend time reviewing photographs with patients to fully understand their expectation of size and shape. Many times this simply raises more questions. I will make measurements and use the implant guides to allow the patient to understand exactly the sizes that are reasonable for their body type and measurements.

Please find an experienced Board Certified Plastic Surgeon and member of the Aesthetic Society using the Smart Beauty Guide. These Plastic Surgeons can guide you on all aspects of facial surgery, breast augmentation and body procedures including tummy tucks or mommy makeovers!

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.