A common concern and question that plastic surgeons get is “what’s the best incision for a breast augmentation?” The choice of incision is a balance between an inconspicuous, hard to see scar, and the assurance of reliably getting the most beautiful possible result. It is important that the incision process is discussed with the surgeon as part of a consultation. Considerations for both the desire and individual of anatomy of each patient must be weighed.
There are four possible incisions for a breast augmentation; below the breast in the fold, around the areola/nipple, through the armpit and through the belly button. The belly button and armpit incisions are remote from the area where the implant is placed and the pocket is blindly created bluntly by pulling the tissues apart. Surgeon’s using these techniques can’t see or feel what he or she is doing. There is the potential for more bleeding and these approaches are more painful. Getting the implants even is also more difficult and the results are more unpredictable as confirmed in studies.
The preferred incision is under the breast and occasionally around the areola/nipple. Extensive experience has shown that the most reliable results come from being able to view within the incision and see the various tissues and muscles while placing the implant. These incisions allow the surgeon to feel the pocket as it is being created, and also to more easily compare sides. The surgeon can see the blood vessels and control bleeding in addition to being able to see the nerves and more them out of the way to prevent numbness.
Incisions usually heal well and are hard to see (keep in mind it can take up to 12-18 months to see the final result). On the rare occasion a scar can be a bit thick or contract a bit. If this happens at the areola/nipple it is easier to see and sometimes hard to fix. Also it can be difficult to get a silicone implant in through the areola. Therefore in our opinion the optimal incision is in the fold beneath the breast, the inframammary incision. Studies have also shown that the inframammary incision has the lowest complication rate.
Like everything else in the breast augmentation procedure the decision of incision is part of customizing the procedure to you to get the best possible result.