Which incision would be best to minimize scarring on me? (photos)

I am between inframammary vs peri-areolar. I appreciate your advice. I already have a scar on my right areola from 10-12 o'clock from a fibroadenoma removal. thank you.

Doctor Answers 20

Which incision would be best to minimize scarring on me?

A peri-areolar incision usually blends in with the pigment of the areolar. So, between a peri-areolar and inframmary incisions I could state that the peri-areolar incision is a better choice - if your surgeon agrees.

San Francisco Plastic Surgeon
4.5 out of 5 stars 8 reviews

Best scar depends on what you desire

and with a scar on the top of one of your areolas, its probably best to avoid that approach.  So axillary is good if your surgeon is experienced and meticulous about creating your pocket and you have to accept a higher risk for contractures when compared to the under the breast incision.  Know your surgeon's revision policy as well as there is more malposition problems when approaching from the armpit (axillary).  If you're fine with your breast covering the scar and the safest approach, then you want under the breast. 

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Transaxillary Incision for Silcone Breast Implants

For the addition of a #BreastImplant with a Breast Lift, we have been using an approach for more than 20 years known as the #Transaxillary Breast #Augmentation. Axillary – with this incision, there are no scars on the breasts. Special training, experience, and equipment may be required for this procedure.
It is our most common and recommended site for silicone implant placement.
The partial muscle coverage will hide the implant better and help avoid visibility of any implant imperfections such as rippling. The appearance will also look more natural.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 109 reviews

Which incision would be best to minimize scarring on me?

From your photo and your desire to hide scars, I believe a sub-muscular breast augmentation via a trans-axillary (armpit) incision will give you a very nice result with the best hidden scar.  Scar in the armpit usually heal very well and are almost imperceptible in 6 to 12 months.  Seek out a plastic surgeon who performs breast augmentation via the various approaches and follow their advice in our case.  Best wishes, Dr. Lepore.

Vincent D. Lepore, MD
San Jose Plastic Surgeon
4.8 out of 5 stars 56 reviews

Breast Augmentation Incision

The answer to this question requires more information. Of the 3 breast augmentation incisions, periareolar, inframammary and axillary, the one that hides the best is the periareolar. However, this is not usually appropriate for the new cohesive gel silicone implants since the length of the periareolar incision is frequently not long enough to allow easy insertion of these implants. If the insertion is not easy, then you run the risk of injuring the implant shell which can cause later rupture (actually shown to be the major cause of implant rupture). The periareolar incision is perfect for saline implants which can be placed in the pocket deflated and then filled, thus allowing a smaller incision. The axillary incision is even more inappropriate for gel implants. For them, the only appropriate incision is the inframammary one since its length can be varied depending on the size of the implant used. If you are using saline implants and choose the periareolar incision, make sure that the right incision is rotated and the old incision is incorporated in it to improve blood supply and sensation (you do not want 2 separate incisions around the areola).

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 6 reviews

Best breast incision for augmentation surgery

Thank you for sharing your photos
You have small breasts, they're different choices: periareolar incision because you have a scar in that area, submamary incision or axilar incision. All these options are discussed on the medical evaluation with a plastic surgeon, where we decide the size, shape and type of implant that we are going to use.

I hope my answer will help you to your question.

Before undergoing any surgical procedure, please seek a board certified plastic surgeon

Jairo Ulerio, MD
Dominican Republic Plastic Surgeon
5.0 out of 5 stars 79 reviews

Optimal breast incision for augmentation surgery.

Thank you for your question and photographs.  I can just imagine the "can of worms" that you have opened and I am sure you are getting multiple different opinions.  I see that you have loose relaxed tissue probably as a result of pregnancy and should be a good candidate for breast augmentation surgery no matter which incision is used.  In light of my my three decades of experience, I feel strongly that you would do well with either an areolar incision or a transaxillary incision.  In my practice I rigorously avoid inframammary incisions since I have seen a few that healed beautifully but many that left visible prominent scars that are permanent.  I have never seen a bad areolar incision and currently use that for the majority of my cases even after two decades of performing mostly transaxillary incisions.  As long as your implants are not going to be particularly large I think you would be a very good candidate for a transaxillary approach with a relatively small and well hidden incision.  Only rarely have I seen a patient form a thick scar in that area nearly all of those few responded to a simple scar revision.  Please enjoy the video above which I think you might find informative and helpful.
Good luck and best wishes.

Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 30 reviews

Incision Placement


Thank you for your question and photo. If you tend to scar visibly/badly then choosing the least visible and easily hidden location in the crease would make the most sense. I recommend that you let your Plastic Surgeon discuss the pros and cons of either with you.

All the best

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 176 reviews

Minimizing Scarring

Considering you have fair skin, both incisions would result in minimally visible scarring. I personally prefer the inframammary incision because the incisions hides well underneath the breast, where as the peri-areolar incision is visible. Also, using this incision avoids cutting directly through breast tissue and can decrease risk of losing nipple sensation. Looking at your existing scar to the right breast, you appear to heal well overall. That being said, I believe that you could go with either and still acheive an optimal result. 

Peter H. Grossman, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 1 review


location of the incision, location of the implant, type of implant, and size are all critical questions for women who choose breast augmentation. The common denominator to the most beautiful breasts is that they were sized objectively on the basis of measurements. We combine a proven formula based on measurements of the rests and chest along with through discussions of patient's desires. Photos of ideal breasts and results from patients with similar breasts are often very helpful in the discussion. Many techniques exist in breast surgery, and the key is working with an expert, board certified plastic surgeon to get the best plan for the individual.

Eduardo Orozco, MD
Colombia 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.