Should I do breast augmentation umbilical approach since I already have a scar on my stomach? (Photo)

I has always wanted to have breast augmentation. However I already has a big and long scar on my stomach, so I prefer not to have other scars. I attached my picture below. My question is would it be possible for me to do breast augmentation umbilical approach (with silicone) or from somewhere through my scar. Also, along with the breast augmentation proceture, can the doctor also reduce the size of my scar. Thank you

Doctor Answers 10

Should I do breast augmentation through umbilical approach since I already have a scar on my stomach?

Thank you for sharing your question and photograph. I think in order to obtain the best result I would recommend a more traditional incision approach - areolar or inframammary crease.  This will allow for greater control of your surgically created implant pocket.  Your stomach scar can be revised during the same procedure to leave you with a more cosmetically appearing incision.  Hope this helps.

Atlanta Plastic Surgeon
4.9 out of 5 stars 65 reviews

Umbilical approach

The result of a breast augmentation depends on how accurately the space is made under or over the muscle before the implant is placed. The infra mammary fold approach gives the most control to the surgeon to accomplish this. That is why the umbilical approach has fallen out of favor. 

Matthias Solomon, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 13 reviews

Should I do breast augmentation umbilical approach

First of all, the umbilical approach for breast augmentation only works if the implants are saline, not silicone. Secondly, very few surgeons do the umbilical augmentation. When a procedure is not popular with most surgeons you should realize it is a bad idea or they would all be doing it. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews

Umbilical approach

Thank you for your question. The umbilical approach for breast augmentation is the least desired of the four possible scar locations including the inframammary fold, periareolaperiareolar, axilla, and umbilical. In addition, it is not possible to place silicone implants through the belly button. Generally, the preferred location of the incision for breast augmentation is in the fold below the breast. I suggest you consult one or more board certified plastic surgeons certified by the American Board of plastic surgery to discuss your options. Seek someone who is reputable with good proven results that can be seen in before and after photos. Hope this helps. Best wishes!

Nicholas Tarola, MD
Nashville Plastic Surgeon
4.9 out of 5 stars 57 reviews

Breast augmentation

Hello and thank you for your question. You are a great candidate for a breast augmentation.  Silicone implants cannot be placed through an umbilical approach.  The umbilical approach also has many other disadvantages such as higher rate of capsular contracture.  I highly recommend an inframammary approach.  This entire surgery can be performed with a small incision technique.  You abdominal scar can undergo scar revision at the same time.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 124 reviews

Should I do breast augmentation umbilical approach since I already have a scar on my stomach?

Thank you for your question. Silicone implants can not be inserted through umbilical approach. Please consider standard breast aug and scar revision to your abdomen.

Ven Erella, MD
Austin Plastic Surgeon
4.9 out of 5 stars 30 reviews

Should I do breast augmentation umbilical approach since I already have a scar on my stomach?

Thank you for your question and photo.  You have nice breast anatomy and should achieve a very nice result from breast augmentation.

Silicone implants cannot be placed through the umbilicus, only saline implants.  I agree with your decision to have silicone implants but he will need to have an inframammary crease incision as your best option.  Placing the implant under the chest muscle through an inframammary crease incision results in fewer complications such as capsular contracture.  For more information please read the link below:

Should I do breast augmentation umbilical approach since I already have a scar on my stomach?

Silicone implants can't be placed through your scar or belly button. Consider a standard breast implant incision with an abdominal scar revision. 

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 68 reviews

Abdominal approach for breast augmentation

Thank you for your questions and photo. If you want to utilize silicone implants, it would not be possible to utilize a isolated umbilical approach. That being said, you do have a large scar on your abdomen, and an abdominal approach could in theory be performed. By this, I mean removal of the scar and dissection up to the breasts through that incision. That being said, I believe that the ability to accurately place the implant would likely be compromised with that approach. Your abdominal scar appears to have possibly had some healing problems. This may have contributed to the width and appearance of the scar. I think you would likely be better off with a small inframammary incision and revision of the abdominal scar. Certainly discuss your concerns with a board-certified plastic surgeon who has significant experience with all incision options for breast augmentation. Best regards.

Anthony Deboni, MD
Syracuse Plastic Surgeon
4.9 out of 5 stars 32 reviews

Should I do breast augmentation umbilical approach since I already have a scar on my stomach?

Thank you for the question and picture.  I think that your scar can certainly be advised ( to a more fine scar) at the time breast augmentation surgery.  In my practice, I would offer you an infraareolar or an inframammary incision approach to breast augmentation surgery.  I prefer to use approaches that allow for direct visualization of the breast implant "pocket" dissection;  in my opinion, this direct approach will allow for more precise dissection (potentially less risk of breast asymmetry).

Generally speaking, the best online advice I can give to ladies who are considering  breast augmentation surgery ( regarding breast implant size/profile selection) is:

1. Concentrate on choosing your plastic surgeon carefully.  Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. ***Ask to see lots of examples of his/her work.

2. Have a full discussion and communication regarding your desired goals  with your plastic surgeon. This communication will be critical in determining  breast implant size/type/profile will most likely help achieve your goals. 

In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of words such as  “natural” or "C or D cup” to "too big on me" etc means different things to different people and therefore prove unhelpful.

 Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup  size may also be inaccurate.  Again, the use of computer imaging has been very helpful during the communication process, in our practice.

3.  Once you feel you have communicated your goals clearly,  allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals.  Again, in my practice, this decision is usually made during surgery,  after the use of temporary intraoperative sizers.

I hope this (and the attached link, dedicated to breast  augmentation surgery concerns) helps. Best wishes. 

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,487 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.