Different Types of Breast Implant Incisions: Which Is Right for You?

February 8, 2023

Written By Joe Gryskiewicz, MD, FACS

Breast implant surgery is a popular option for women desiring more voluptuous breasts. Breast implants come in many shapes and forms and their characteristics determine the result of the surgery. However, it is not just the shape, size, and filling of the implants that are important, but also the implant placement and incision. Some breast implant incisions are more visible than others, but all incision types have pros and cons.

Dr. Joe is a talented Minnesota plastic surgeon with over three decades of experience in performing breast procedures. During your consultation with Dr. Joe, you will discuss all the details of the breast augmentation surgery, including breast implant incisions.  Dr. Joe has placed thousands of implants through each incision with both gel and saline implants.

Where Are the Incisions for Breast Augmentation?

If you are considering breast augmentation surgery, then you likely have a lot of questions. One question that many women ask is: “Where will the incisions be?” The incisions for breast augmentation can be made in three main areas:

• axillary (in the armpit),
• periareolar (around the areola),
• inframammary fold (below the breast).

The decision of where to make the incision depends on several factors including the size and shape of the breast, the type of implant used, as well as patient preference.

1. The Axillary Incision

The axillary incision is typically suitable for all sizes ofimplants, because it allows for more control over placement and does not require an incision on the breast itself. Not having scars on or under your breasts is probably the main reason why patients choose this type of incision. Also, the axillary approach allows for a shorter recovery time compared to other methods. It is not difficult for Dr. Joe to insert larger implants using this technique – in fact he wrote a published paper in The Aesthetic Surgery Journal on large gel implants inserted through the armpit. It’s important to discuss possible risks and benefits with your surgeon before deciding if axillary incision breast augmentation is right for you.

2. The Periareolar Incision

Periareolar incisions can be used for a range of implant sizes. This type of incision gives the surgeon access to the area behind the nipple and can provide more visual control over implant positioning.

Another benefit of the periareolar incision is a pretty good-looking scar– the incision is performed at the edge of the areola, where the darker tissue of the areola meets the lighter skin of the breasts. Keep in mind that if you are prone to abnormal scarring (such as hypertrophic or keloid scars), the periareolar incision might not be recommended due to the visibility of the area. There is a much higher chance of nipple numbness.

3. The Inframammary Fold Incision

The inframammary fold incision is made in the natural crease beneath the breast, where the breast meets the chest wall. It is typically a short incision of about 2-3 cm long that allows for access to underlying tissue and implant placement. This incision provides accuracy for your plastic surgeon as it gives access to areas behind the glandular tissue and chest muscles. The inframammary approach also offers good control over pocket location and size, allowing for optimal positioning of implants.

Factors That Influence the Choice of Incision

No matter where your surgeon decides to make the incision, rest assured that he will take great care in making the incision as small and discrete as possible. However, some incisions are indeed more visible than others. Ultimately, the placement of the incision will depend on several factors and should be discussed with your surgeon to come up with the best plan for you.

The choice of incision for a breast augmentation is influenced by many factors including:

• Size and shape of breasts.
• Type of implant used (saline or silicone);
• Most importantly patient’s preference.

Choosing an incision that is appropriate for a particular patient requires careful consideration from both the patient and the plastic surgeon.

Pros and Cons of Breast Implant Incisions

Each type of breast implant incision has its own advantages and disadvantages. Here is a brief overview:

• Axillary – This incision is made in the armpit and is not visible. Most woman want to avoid a cut on their breasts.  The axillary incision is called the Asian Breast Augmentation, and we have a separate blog on this.
• Periareolar – This incision is made around the areola and gives good access to the implant pocket. It allows for precise placement and can help reduce scarring. However, it may cause damage to breast tissue and milk ducts, leading to possible breastfeeding issues and numbness in some cases.
• Inframammary fold – This incision is made below the breast in the fold between the breast and chest wall and is usually used for larger implants due to its access to the implant pocket. The scarring here is often less noticeable but can cause some discomfort and soreness during recovery. Inframammary is preferred if there is minor relaxation (ptosis) of the breast tissue.  Then you can do the dual-plane internal breast lift – see references.

What Is the Most Common Incision for Breast Augmentation?

The most common incision for breast augmentation is the inframammary fold incision because of its access to the implant pocket. In California and in Dr. Joe’s practice (82%), the axillary incision is the most common incision.  This inframammary incision gives good access to the implant, allowing for precise placement of the implant, and the scarring is usually less noticeable. More than this, this incision is often used for revision surgery too.

Healing Times for Different Breast Implant Incisions

The healing times for different breast implant incisions vary depending on the size and shape of the breast, type of implant used, as well as patient preference.

Choosing the Right Type of Breast Implant Incision for You

When it comes to selecting the right type of breast implant incision for you, it’s important to consider your individual anatomy, desired outcome, and the skill of your surgeon. Dr. Joe will be able to discuss the pros and cons of each incision type and help you make an informed decision about which incision is best for you. Just ask yourself, where you want to live with the scar for the rest of your life.

At the end of the day, it is important to remember that breast augmentation is a personal decision and one that should be made with careful thought and consideration. While there are some considerations regarding where incisions will be placed, ultimately it is up to you and your surgeon to decide what works best for you. No matter which incision site is chosen, it is important to remember that with proper care and maintenance post-surgery, scars can fade over time. With this being said, if you have any additional questions or concerns about where the incisions may go, make sure to bring it up with Dr. Joe during your consultation.

Further Reading about Breast Surgery at Twin Cities Cosmetic Surgery

• Quick Recovery^® Breast Augmentation
• Breast Augmentation with a Lift
• Dual Plane Breast Augmentation
• Gryskiewicz, J.M., LeDuc, R.   Transaxillary Nonedoscopic Subpectoral Augmentation Mammaplasty: A 10-Year Experience with Gel vs Saline in 2000 Patients- With Long-Term Patient Satisfaction Measured by the BREAST-Q. Aesthetic Surgery Journal 34(5):696-713,  July 2014.
• Breast Augmentation Gallery

Medical References about Breast Implant Incisions

• Breast Augmentation Incision Placement – My Plastic Surgeon
• Breast augmentation incision sites – Mayo Clinic
• The five factors of breast augmentation – ASPS
• How Long Before Incision from Breast Augmentation Heals?