Because breast augmentation is a surgical operation, it is impossible to completely eliminate the need for a surgical scar. The goal is to make that scar as small and inconspicuous as possible.
Currently there are 3 main choices of incision site for breast augmentation:
• Transaxillary – incision is in the underarm
• Periareolar – incision is in the lower border of the areola
• Inframammary – incision is beneath the breast
In my opinion, hiding the skin incision in the underarm has been the single biggest improvement in breast augmentation surgery in the past 20 years. The transaxillary or underarm incision allows the procedure to be done with no visible scars on the breast. Breast augmentation using an underarm incision has been a uniquely successful aspect of my breast surgery practice and I have performed over 1700 transaxillary breast augmentation procedures.
Although the underarm incision is desirable, it is not appropriate for all breast augmentation patients. Those patients with more than moderate breast overhang, or those with a tight lower curvature may need a periareolar incision to allow greater control of the breast shape. An incision under the breast is usually reserved for those women who require large, firm cohesive implants to correct a breast shape that has settled a significant amount.
The decision regarding implant incision site should be carefully decided during the pre operative consultation with your surgeon. If you are considering a specific incision site and/or a specific implant, make sure to discuss the implications of your choices – sometimes ideas that are posted on the internet are misleading. Have an open mind at the consultation appointment and be prepared to consider the surgeon’s recommendations for the incision site based upon your anatomy. An open dialogue during the pre-op discussion goes a long way towards planning a safe and successful procedure.