What is the Best Way for Implants to Be Inserted?

Doctor Answers 12

It Depends On Your Body and Preference

This is a very personal decision that you and your surgeon will have to determine. As you probably already know, there are three incision placements: through the armpit (trans-axillary), around the areola (peri-areolar) and underneath the breast, where it meets the body (infra-mammary). There is also an incision in the belly button (trans-umbilical), however this is very uncommon because not only is it available solely to patients opting for saline, it also makes it more difficult to position the implant. Revision breast augmentation through this incision site is also impossible.


In my experience, the infra-mammary fold has been the most effective in achieving the expectations of my patients. I find that with this incision site, the implant can be placed below or above the muscle (sub-muscular or sub-glandular) in the most aesthetically pleasing position with the least risk of complications. I can feel any areas that need to be filled out with the implant better, so that it may sit more naturally. This is particularly important for the lower portion of the breast, to achieve a smoother and fuller contour. The other incision sites do not allow for this as efficiently or effectively. That being said, however, I do use all three incisions, depending on a patient's particular situation and preference.

Toronto Plastic Surgeon
5.0 out of 5 stars 176 reviews

For most women, breast implants are best put in through short incision in the fold under breasts.


This scar really fades.  The thing to understand is that what's hard about breast augmentation ( and what will determine whether you are happy or not ), is getting the SHAPE pretty and natural.  That's why I often use this incision.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

Breast Implants

There are several ways that breast implants can be inserted, and each technique has both advantages and disadvantages.  The most common incisions used today are in the crease under the breast, around the areola, or from an incision under the arm.  Discussing the options in detail with your surgeon is always recommended, since one incision isn't necessarily the best option for all patients.  The risk of each incision including postoperative discomfort, risks of needing additional surgery, capsular contraction rates, and possibly loss of nipple sensation should also be discussed when you meet with your Plastic Surgeon.

John K. Wakelin III, MD, FACS
Columbus Plastic Surgeon
4.9 out of 5 stars 43 reviews

Is there a best way for breast implants to be inserted?

Thanks for your question!

There is no single, best way for breast implants to be inserted.  This is actually a very involved discussion that you should have with your board certified plastic surgeon.  You should have all the information before deciding.


There are two main questions. The first is, "Where will the incision be located?"  Will it be around the nipple, below the breast near the inframammary fold, through the armpit, or through the belly button.  The second is, "In what plane will the implant lie, in front of or behind the chest pectoralis muscle?"


Each of the above choices represents a joint decision arrived at by the patient and the surgeon.  Each choice has its own advantages and disadvantages.


Your best solution is to make an appointment with your doctor so that you can freely discuss all your concerns. Your physical exam will also be critical in making these decisions.

Shankar Lakshman, MD
Pasadena Plastic Surgeon
5.0 out of 5 stars 3 reviews

Which incision is best in breast augmentation? Choose transaxillary!!!

You will see a lot of different opions from different surgeons but I believe the answer is really simple.  You must determine wherther or not a breast lift or nipple reposition is injdicated and if so, does the patient feel that she would prefer a nicer shape and more scars.  If this is the case, the incision is already dictated by the type of lift being performed and there is no issue.  If a breast lift is not indicated or accepted by the patient, why the heck would you put a scar anywhere on the breast???? 


Thus I ALWAYS perform trans-axillary placement when no lift is being performed.  The scar really disappears in most patients and even when it is healing is not seen by anyone.  You can easily place large silicone implants throough a transaxillary incision.  all breast incisions including circumareolar change the outward appearance of the breast and are telltale signs that they are not natural.  An inframammary incision may showbelow swimwear and be embarassing.


transaxillary is the way to go!


I hope this helps!


All the best,


Rian A. Maercks M.D.

Rian A. Maercks, MD
Miami Physician
4.9 out of 5 stars 73 reviews

What is the Best Surgical Approach for Breast Augmentation

Other than "how big will I be with this implant?" the most common question that patients have is "which incision is best?" In my opinion, boils down to two things- your breast anatomy and the patient's preference for scar placement.


Choices- There are three common surgical incisions for breast augmentation: Periareolar, inframmamary, and transaxillary. Periareolar incisions are placed along the lower edge of the areola at the junction of the pigmented and non-pigmented skin. Inframmamary incisions are placed within the fold under the breast, and trans-axillary incisions are within the armpit creases.


Anatomy- If a woman has a very small or pale areola, it may be difficult to place an implant through this approach or to hide the scar adequately. Similarly, if the unaugmented breast does not have a defined fold, an inframamary scar may be more visible than desired. Axillary scars are typically very well hidden and leave no scarring on the breast, but may be initially noticeable until the scar completely matures when lifting the arm.


Patient Preference- Ultimately, all three surgical approaches can give you great results. In our practice, the choice of incision is usually left to the woman based on where she wants the scar to rest.

Lawrence Iteld, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 39 reviews

Brasst implant incision

There is no one best route to place implants.  the two most common routes are around the border of the areola, and through the breast fold.  They both give good access for most procedures.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews



There is many ways to insert an implants, all practice are different. In our practice we use through the areola, breast crease and armpit. In our practice we do more of the Areola since the skin is thinner and the scar is more forgiving.


Stuart B. Kincaid, MD, FACS (in memoriam)
Beverly Hills Plastic Surgeon
3.3 out of 5 stars 9 reviews

The best way to place breast implants

Surgeon and patient preferences vary and truly there is no best way, however the three most common ways to place breast ilplants are preiareolar, inframammary, and transaxillary. Perhaps your surgeon can help you understand the trade-offs of all three.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 42 reviews

There is no best way

Go for a consultation and talk to the doctor. Each of us has a favorite way. Personally, I like the circumareolar scar as I feel that the scar is the least visible and if you need further surgery, it can be done through the same scar. All scars can heal poorly, and no matter which approach is used the complications can be the same.


Talk to your doctor.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.2 out of 5 stars 12 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.