Incisions for Breast Implants

What are the three incisions used?

The infra-mammary incision is the most common incision used for breast augmentation. This incision is located in the crease where the breast meets the chest and leaves a well-concealed scar below the breast. Direct visual access to the implantation site facilitates accurate breast implant placement with a low likelihood of malpositioning and asymmetry. All sizes of breast implants can be surgically positioned through an infra-mammary incision. This incision is particularly suitable for larger-sized silicone breast implants.

The peri-areolar incision is located on the lower border of the pigmented skin surrounding the nipple (lower margin of the areola). A natural pigmentation change between the areola and normal skin serves to camouflage and conceal the resulting breast augmentation scar. This access incision also permits direct visualization of the surgical pocket for final silicone breast implant placement. The length of the peri-areolar incision is limited by the circumference and size of the areola. Not all sizes of silicone breast implants can be placed through this incision.

The trans-axillary incision is hidden in the armpit and is remotely located from the breast. With this incision, a collapsible saline breast implant is preferred. The smaller dimension of the deflated saline breast implant facilitates its positioning through the tight confines of this remote incision. The implant is filled at surgery only after manipulation into its desired position. Modest or smaller-sized prefilled silicone smooth breast implants can also be positioned through the trans-axillary incision. Direct surgical access for pocket creation is not possible. The creation of a well-contoured symmetric lower breast pole remains a problem with the remote trans-axillary access. The resulting scar on the armpit might be visible with sleeveless attire. Women who often wear sleeveless apparel might consider another choice of incision for their breast augmentation.