Best Incision Site for Droopy (Not Overly Saggy) Breasts? (photo)

I was told that an armpit incision for droopy breasts would cause the implant to sit high and therefore cause the bubble effect. Would like some varied opinions on this subject before I make my decision. My aureola is not highly pigmented so I'm wondering if an incision there would be easily hidden. Thank you.

Doctor Answers 8

Breasts and sagging

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It is difficult to say what you exactly need without an exam. Your photos angle is a bit from below and it would be nice to see it in person.  Sometimes if you need just an areola lift, it can be done in a circumareola fashion.

New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Best incision site

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From the one photo you sent, it doesn't seem as though your breasts are too saggy.  I believe the most inconspicuous incision site for you, if you are considering breast augmentation, is just above the fold below the breast.

Michael Leff, MD (retired)
Bellevue Plastic Surgeon

Where to put my Breast Augmentation Incision?

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Very difficult to answer without better pictures and a examination. I use the armpit incision and the breast fold incision. I believe that the areola incision can change nipple sensitivity and that it increases the risk of the implants scarring/hardening therefore I do not use it. If your breasts sit low on your chest, I do not usually recommend the armpit incision unless you will be vigorous with your post-op massages and be patient and allow the implants to drop. The breast fold incision always works well. Good luck.

Jonathan Weiler, MD
Baton Rouge Plastic Surgeon
4.9 out of 5 stars 93 reviews

Best Incision Site for Droopy (Not Overly Saggy) Breasts?

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Thanks for the posted photo. The edge of your areolar and the breast skin is not easily seen, therefore there is a possibility that an circum areolar incision could be noticeable. Also with the risk of decreased sensitivity and issues with breast feeding make using that exposure a risk. While you are correct in axillary incisions lend to poor inferior/medial dissection causing higher riding implants. Thus I come to infra mammary incisions as in your case a very good choice. But any of the 3 would work it is a choice after being presented all the risk/benefit ratios. Good luck. 

Droopy breasts & implant incisions

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You should be able to get great results with the axillary (armpit) incisions, if the surgeon doing your surgery is experienced in that technique.  Whatever plastic surgeon you choose, be sure to follow his/her advice, since their experience will dictate what he/she feels most comfortable doing.  Hia/her experience will affect your results.  Any incision should be OK for you. 

Amy T. Bandy, DO, FACS
Newport Beach Plastic Surgeon
4.9 out of 5 stars 109 reviews

Sagginess and breast implants.

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The photos are helpful, but a direct exam is needed to give you a definitive answer. It is also highly dependent on what size implants you choose. I would not recommend going with a larger implant to give the lift, but stick with the size that fits your body the best.


Using an inframammary (below the breast) incision would hide nicely in the crease and shadows of the breast while allowing a biplanar technique that helps the breast lift better and potentially negate the need for a minor lift. Seek consultation from a reputable surgeon in your area and good luck.

Brian J. Lee, MD
Fort Wayne Plastic Surgeon
5.0 out of 5 stars 13 reviews

Best Incision for Breast Augmentation?

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Thank you for the question and picture.

It is not possible to give you precise advice without direct examination and a full communication of your goals.

One of the concerns I would have with patients in your situation, is if breast lifting would be helpful. Much of this decision-making will depend upon your physical examination.

My personal preference would be to use an incision under your areola if breast augmentation alone is decided upon. Otherwise, I am concerned about precise implant positioning with an incision under the axillary area. The scars under the areola tend to blend in well for most patients; sometimes scar revision surgery may be necessary to improve the appearance of the scars. 

I hope this helps.


Any incision will work - the bubble effect is related to the implant diameter

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Thank you for your question.  I assume that you are referring to the double bubble effect.  This is not related to the incision.  Any incision will work.  Doube bubble is caused by an implant that has a larger diameter than the overlying breast.  If you chose such an implant, when you lift your arms, your breast tissue lifts and you would see the wider diameter implant below.  It looks like a "double bubble".  There are so many implant options that your surgeon can get a narrower based implant with better projection.  This allows you to have the size breast you want and avoid the double bubble.  In addition, a more projected implant will create a better "lift effect" for your slightly low nipple and areola.  Ask your surgeon about Natrelle Inspira extra projection or Mentor ultra high profile round implants.  Also, dont neglect to consider the infra-mammary incision.  It heals well, causes no sensation changes in the nipple long term, provides great exposure for your surgeon and is hard to detect after a few months.  I hope this provides some helpfull information.  Dr. Scott Barr

Scott Barr, MD
Sudbury Plastic Surgeon

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.