Which is Better and Less Painful, Armpit or Aerola Incision?

Great question!  The armpit or trans-axillary incision's main advantage is that it is hidden in the armpit, far from the breast and not visible even without clothing.  The distance from the pocket is an issue so only saline implants rather than pre-filled silicone implants are typically used.  The peri-areolar incision heals fairly well and can be used for either saline or silicone implants.  It is usually not a very painful incision but it can be associated with a higher risk of loss of nipple sensation or hypersensitivity.  The inframmmary incision is well hidden in the fold of the breast, allows either a saline or silicone implant to be used and the risk of nerve injury is fairly low.   The umbilical incision has the same advantages and disadvantages as the trans-axillary approach.  Additionally, special instrumentation and experience is required.  If there is bleeding with any of the remote incisions, an inframmmary approach could be required to address it.  Please take an extra moment to discuss your concerns with your surgeon as well as the pros and cons of each technique.  If you are going to use silicone implants, a peri-areolar or inframammary incision seems most prudent.  Good luck!

   In general, the risk for infection and capsular contracture may be greater for armpit and areolar incisions for different theoretical reasons.  I prefer the transumbilical, MF, or periareolar for saline and the IMF or periareolar for silicone.  The pain is due to placing the implant under the pectoralis major muscle, and I do not think any of these incisions is necessarily less painful.  Kenneth Hughes, MD Hughes Breast Augmentation Los Angeles, CA

Hello,

Thank you for your inquiry.

The 400cc silicone implants inserted from the armpit will result in a fairly visible a scar in the axilla with a higher chances of CC due to possible bacterial contamination. 

As for the insertion from around the areola, another visible scar will be placed at the point of entry. However, this method may be beneficial if you have decided to have a circumareolar (doughnut) lift.

Finally, the inframammary insertion may be the best bet in terms of aesthetics and low infection risks.

I encourage you to communicate your concerns and thoughts with your surgeon before your surgery so both of you would be on the same page.

I hope this helps and the best of luck to you.

Dr. Sajjadian