Breast Augmentation Incision Placement Options

When considering breast augmentation, incision placement is an important aspect to discuss with your surgeon. Though plastic surgeons use their skill to make incision scars as inconspicuous as possible, their placement can play a important role in a patient's satisfaction with her results.

The three most common incision options are:
*Inframammary (crease beneath the breast)
*Periareolar (following the line of the areola)
*Axillary (within the folds of the armpit)

Each of these incision options offer their own advantages and disadvantages to consider. The Inframammary option, for instance, allows the best surgical access to the breast, therefore the most control over how the implant will look in a patient after surgery, as well as access to correct issues of breast shape and sagging. This option is best in women with enough breast volume to cover the incision, concealing it from view.

The Periareolar option creates a smaller scar than the inframammary, so it is appealing to many breast augmentation patients. With this option, a tunnel is created through the breast tissue for implant placement. The size of implant that can be used with this incision option depends upon the patient's areolar size. With this option, the risk of loss of nipple sensation is slightly higher than with other options. There is also evidence that the risk of capsular contracture (the hardening of tissue around the implant) is also greater with the periareolar incision.

The Axillary incision option offers the advantage of no scarring on the breast at all. The incision is concealed within the folds of the armpit and a tunnel is created to the breast area. This option offers a lower risk of sensation loss and capsular contracture than a periareolar incision. This is a good option for women seeking enlargement, but no extensive lifting or reshaping of the breast. It can accommodate implants of up to two cup sizes.

For women considering breast augmentation, San Jose plastic surgeon Dr. Robert Lowen suggests choosing an incision option based on desired breast shape rather than scar placement.

"Wherever the incision is placed, favorable healing usually results in scar that is thin and barely detectable after the usual six to 12 months required for scars to mature. This means that if the ultimate goal is optimal breast shape, and if that shape may be best achieved by one or two but not all three of your incision location choices, the trade-off is usually well worth it."

Dr. Lowen does warn, however, that predicting which patients will heal with less optimal scars can not be predicted. "Healing is affected by genetic factors over which we have insufficient knowledge and control to predict final appearance in any given individual. However, we do know how to create and suture incisions to accommodate the breast implants, and how to place them to make the scar as favorable as possible."