Breast Augmentation – Decisions on the Incisions

One of the most important decisions when having breast augmentation surgery is the type of incision.

Currently, there are 4 different procedures.

Dr John suggests anyone thinking of a boob job should do a bit of homework beforehand and then discuss the options with their surgeon.

Below we look at all the options:

The Inframammary Fold

The implant is put in under the breast where the crease is. This is the most common approach and is widely regarded as the best method.

The pros:

  • Has lowest complication rate
  • Known to heal very well
  • Revision can be performed via this type of incision in future
  • Lower risk of breastfeeding difficulties or change in nipple sensation
  • Scarring isn’t visible from face-on
  • Surgeons have greater control over bleeding due to the proximity of the area being operated on

The cons:

  • Scars may migrate upwards onto the breast should they get bigger
  • If the breasts get smaller from a breast reduction, the scar may migrate downwards and be visible below the breast
  • Sometimes requires a surgeon that is very experienced/skilled

The Periareolar

The implant is put in by making an incision at the outer edge of the areola and following the curve that separates the darker skin of the nipple from the rest of your breast.

The pros:

  • Heals nicely and scar should be hidden by the areola’s natural texture and pigment
  • Can provide a very precise placement of the implant due to the proximity of the incision to the breast
  • Can be reopened should future surgery be desired

The cons:

  • There is a limitation in the size of the implant that can be placed
  • Some women report changes in nipple sensation
  • May come with issues surrounding difficulty in breastfeeding
  • Higher risk of infection
  • Higher rate of capsular contracture (where the body reacts to the implant in a way that can distort the shape of the breast and cause pain)
  • Those with small nipples or pale areolas may not be suited to this method

The Transaxillary

The implant is put in by making an incision in the armpit and creating a tunnel to the breast so that a pocket can be formed for insertion.

The pros:

  • No visible scars on the body besides the armpits
  • Leaves actual breasts technically untouched, meaning less potential damage to the mammary glands – preferential to those hoping to breastfeed

The cons:

  • Generally associated with a greater rate of malposition and provides the surgeon with less control
  • Same scar cannot undergo any revision surgery
  • Size of the implant that can be used is limited
  • Greater rate of capsular contracture
  • Possibility of losing sensation in the armpit
  • The scar can be noticeable in short or non-sleeved clothing

The Periumbilical

The implant is put in via an incision along the belly button and creating a tunnel through the abdomen. The implants are then passed through and are placed in the desired area. This is the least common method.

The pros:

  • Provides a means of hiding the scar well – it is hidden within the folds of the navel
  • Sensation of the nipples are maintained
  • Breasts remain untouched so there are no issues surrounding hopes for breastfeeding in the future
  • The recovery time is shorter

The cons:

  • Due to the incision being fairly far away from the breasts, access is indirect and makes it harder for the surgeon to accurately place the implants
  • Unpopular method due to risks of poorly positioned implants and unnatural results
  • Has a higher complication rate than its counterparts
  • Scar cannot be reopened or revised in the future
  • It is only an option for saline implants

Are you interested in undergoing breast augmentation surgery, or simply would like to know more? Reach out to Dr John and his friendly team here!


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