Common Breast Augmentation Incisions

Breast augmentation is a procedure that is performed for a variety of reasons. Some of the reasons patients might want to undergo an augmentation include a desire to increase the overall balance of their figure, breast reconstruction after a mastectomy or a desire to improve their self-image or self-confidence. No matter what the reason is for a breast augmentation procedure, the total augmentation amount that is best for the body needs to be determined by a board-certified doctor. The doctor will decide what type of incision will be used, and is also appropriate for the figure of the patient, during the procedure. There are four incision types commonly used by surgeons during breast augmentation procedures and they are inframammary, transaxillary, transumbilical and periareolar incisions. In order to help patients make an informed decision when meeting with a doctor, let’s take a look at the various types of incisions listed above.

Breast Augmentation Incision Choices

An inframammary incision is the most common type of incision used on patients. This incision is made by the surgeon in the skin fold of the breast AKA the area where the lower part of the breast tissue connects to the wall of the chest. Once the surgeon makes the skin incision, a breast implant pocket is created and then an implant made of saline or silicone is placed either below or above the breast muscle.

A transaxillary incision uses the natural folds of the armpit to keep the scar hidden from view. The surgeon makes the incision and then creates a small channel to the breast in order to make a pocket where the implant can be placed. Saline implants are the preferred choice for the transaxillary method because they are deflated and can easily be put in place by the surgeon.

Periareolar incisions are incisions that can be found around the circumference of the patient’s areola. To make this incision, surgeons will follow the natural line that separates the dark pigmentation of the nipple from the rest of the skin.  Following the natural line allows the scar to be almost undetectable by others. There can be a few problems with this incision due to the fact that silicone implants have to be placed perfectly by the surgeon as well as precisely adjusted once they are placed. Because of the need for such precise placement, a periareolar incision makes the use of shaped silicone implants rather difficult.

Transumbilical incisions are the most limited incisions used by doctors when performing a breast augmentation. In this method, the incision is placed at the navel so saline implants are the only option since the implant must be inserted while deflated. One good aspect of the transumbilical method is the fact that it leaves almost no visible scar once the patient is done with the healing process.

Patient Breast Incision Concerns

Many patients worry about having an incision on their body but, according to Dr. Jonathan Kaplan, MD, MPH, there are times when an incision is not necessary. Dr. Kaplan says, “When people talk about “going through the nipple”, that’s actually not an incision that is used. No implant goes through the nipple but it can be placed through an incision along the lower edge of the areola AKA the pigmented area around the nipple. If a patient wants a particularly large implant, this can prove to be difficult through the armpit incision.” Dr. Kaplan went on to add, “If the areola is small then an incision along the areola edge would be smaller. In cases such as this, the patient can opt for the incision under the breast in order to accommodate the larger implant. In more straightforward breast augmentation procedures, most of the incisions listed above are the most commonly used options.”

The Location of the Incision has Little Effect on the Procedure Cost

Many patients base the decision of whether or not to have a procedure on the cost involved with the surgery. According to Dr. Kaplan, “Whether an incision is placed under the areola or under the breast doesn’t usually affect the cost. A doctor may charge more for an incision in the armpit since additional equipment like cameras and long instruments are necessary to place the implant through that incision.” In general, patients can expect to pay anywhere from $4000-$8000 for a breast augmentation procedure. 

Risks of Breast Implant Procedures

No matter which incision is chosen, all breast implant procedures have a risk of capsular contracture. Capsular contracture is a response of the immune system to foreign materials in the human body. Medically, it occurs mostly in context of the complications from breast implants and artificial joint prosthetics. The occurrence of capsular contraction follows the formation of capsules of tightly-woven collagen fibers created by the immune response to the presence of foreign objects surgically installed in the human body such as breast implants, artificial pacemakers and orthopedic prostheses as well as biological protection by isolation and toleration. Capsular contracture occurs when the collagen-fiber capsule shrinks, tightens and compresses the breast implant much like the collapse of a bubble gum bubble. It is a medical complication that can be painful and discomforting and might distort the aesthetics of the breast implant and the breast.

Implant ruptures can also happen but, thankfully, they are not a huge safety risk. The recovery time is dependent on the choice of the incision as some methods have a recovery time of a week while others require multiple weeks. The recovery process will see some swelling, bruising and bleeding as a result of any of the incisions.

Breast Augmentation Consultation

Before making a final decision on which incision to have during a breast augmentation procedure, patients should consult with a board-certified doctor. An experienced doctor will set realistic results expectations as well as help the patient determine which incision is the best choice to achieve the desired results.