In general, there are 4 breast augmentation incisions. All of them have advantages and disadvantages, and you should always talk to your operative plastic surgeon for the best option for you.
The 4 incisions are
– breast fold or IMF/ inframammary fold
– areolar incision
– underarm, or axillary incision
– belly button, or umbilicus
The breast fold incision has now become my preferred incision. This incision has a slightly lower infection rate than the areolar incision, because I’m not making an incision through the areola. It’s a versatile incision that allows me to make a pocket for the breast implant immediately where the breast tissue is. After breast augmentation, it’s hard to see, because it’s hidden under your breast implant.
The areolar incision is the same length as the breast fold incision, but the incision is curved, along the brown circular edge of the areola. Theoretically, it has a slightly higher risk of infection, because the milk ducts and skin area of the areola has a higher bacteria count than the breast fold. However, for certain breast conditions, such as tuberous breast deformity, it’s actually the preferred incision. It also allows me to make a pocket directly where the breast implant should be.
The underarm incision is an incision in one of the underarm or axilla folds. I created a tunnel under the pectoralis muscle, and then create a breast implant pocket for the implant. The problem with the underarm incision is that there is much more swelling than the breast fold or areolar incisions. This is because of the tunnel created with the surgery. This swelling goes down, but it takes several months, as well as consistent implant and muscle massage, to reduce the swelling.
The belly button incision uses special equipment to make a tunnel from the belly button to the breast area. Only saline breast implants can be used for this procedure, not silicone. Also, it’s much harder to control the pocket creation compared to the other 3 incisions. It’s becoming less popular, since silicone implants are making a big comeback in terms of their use.
There are many more subtleties involved, but in the end, these are the major choices you have in breast augmentation incisions.