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

There was a time about 20 years ago when the armpit approach was quite popular.  But its popularity has waned for several reasons.  First of all, while you don't have a scar on your breast, you do in your armpit and this can sometimes be visible (hairdressers, volleyball players...).  Most women eventually have subsequent surgery to replace implants or treat problems and these are usually done using an inframammary incision, so now you have four scars rather than two.  Plus, the armpit approach is more difficult for the surgeon: asymmetry is more likely and it can be a challenge to get the cleavage just right (and it is equally invasive).  I'm not sure one approach is more or less painful than the other.  I think all submuscular procedures are probably about the same in terms of pain.  A periareolar scar is also a good option, as recommended by your surgeon.  You don't want to insist that your surgeon use an approach that he or she is not comfortable with or uses infrequently.  Recovery to full activity is about a month regardless of the approach used.  Breasts can be touched right away.  Steristrips on incision usually come off in a week.  There are some examples of inframammary approaches on my website and periareolar (J.S.); the scar is nicely hidden in the crease.  A link is attached.

HI,

 

There is not a great deal of difference in post operative pain from different incision sites following  breast augmentation surgery. 400 cc silicone implants are fairly large implants and will be more difficult to place through a trans-axillary approach. There is recent evidence that implants placed through either the armpit or peri-areolar approach have a slightly increased risk of post- operative capsular contracture due to small amounts of bacteria located in the glands of the skin of those regions, and thus I recommend an infra-mammary approach for you. The new breast crease is also very effective at hiding the incision.

All my best,

Daniel  A. Medalie, MD