There may seem to be an endless number of choices to be made for women who have chosen to undergo a breast augmentation cosmetic surgical procedure, from silicone versus saline implants to implant size and profile to placement in front or behind the pectoral muscle, to the incisional approach. These are all crucial decisions that will affect the procedure and breast appearance and subsequent patient satisfaction. During the consultation, we will carefully examine all the options with patients, including which incision technique will be used to perform the breast implant procedure. The approach used for the procedure can affect implant placement, the severity of scarring, and the future ability to breastfeed.
Four Incision Approaches to Breast Augmentation
There are four basic incision approaches to the breast augmentation procedure.
- Transaxillary: This technique involves a small incision in the armpit. Saline implants may be used with this approach, which is filled after placement in the breast. Smaller silicone implants may also be placed via the transaxillary incision.
- Periareolar: This approach involves a small incision around the areola (the darkened breast skin around the nipple). While this results in the most minimal scarring, there is a greater risk of losing nipple sensation.
- Transumbilical: This approach goes through an incision in the belly button. It can only be used with saline implants, which are filled after they are placed. Like the periareolar approach, the periumbilical approach results in minimal scarring. However, it is more difficult for the surgeon to place the implants accurately.
- Inframammary: This is the most popular approach and places the implant through an incision made at the inframammary fold, where the lower breast meets the chest wall. It can be used with either saline or silicone implants. Its advantages and disadvantages are discussed below.
Disadvantages of the Inframammary Approach
The inframammary approach’s main disadvantage is that it leaves a more noticeable scar than the other techniques. The scar is about 1.5 cm to 5 cm in length. The scar is well hidden in the breast’s crease and is not usually seen when patients are wearing a bra or bikini top. However, the scar may be visible when patients raise their arms over their head or lie down.
Advantages of the Inframammary Approach
The most significant advantage of the inframammary approach over the others is that it provides the most direct and visible route for implant placement. This means a considerably shorter operation time than with the other approaches, which may reduce the chance for subsequent infection or hematoma formation. Furthermore, it provides the best means to achieve placement symmetry and, in the case of saline implants, to match the two implants’ volume amount.
We work with each patient to determine which approach best suits their needs and allows for a safe procedure and a quick recovery, with minimal scarring.
*The content in this blog is developed to spread the awareness towards plastic surgery. Our blog is not intended to serve as a replacement for an actual in-office consultation with Dr. Marin. As such, the information within this blog reflects the unique cases of our individual patients.