There are many things to take into consideration when you are researching breast augmentation. One of the most important is deciding upon the entry point of your implants. There are three standard incisions: the transaxillary, the inframammary and the periareolar. Each incision has merits and drawbacks: you and your surgeon will discuss which one is best for you.

Breast Crease (Inframammary Fold) Incision

The inframammary incision is one of the more popular incisions, since the scar is hidden within the breast's natural fold and is not easily seen when in a swimsuit or lingerie. . It also gives the surgeon a great deal of control over the implant placement.

The incision is made just above the breast crease (inframammary fold), underneath the breast. A new, lower crease will be created by the larger breast. The surgeon must estimate where the incision will sit in relation to the enhanced breast. A wrong placement will possibly make the incision visible.

The implant can be placed or removed above the muscle or below. It is also the most favored incision for it's use in revision surgery. Should you need a revision, the exact, original location can be reopened. This means no additional scars (such as in a transaxillary incision needing revision) and no additional risk of nipple sensitivity that a periareolar Incision could cause.

One drawback to inframammary placement is when the patient desires either larger or smaller implants than she currently has. An implant must be centered behind the nipple to look natural. When a woman decides to go much bigger, the scar will be located higher on the breast. If you go to a smaller implant, the inframammary fold will be higher, exposing the scar in a lower position, possibly in view when wearing a bra or swimsuit. Therefore it is important to listen to the recommendations of your surgeon concerning your eventual size.

Arm Pit (Transaxillary) Incision

The transaxillary incision is also a very popular incision. It is located in the armpit and therefore leaves no scar on the breast; you can see it only when you raise your arm. There may be a lighter color to the scar than the surrounding skin, but otherwise the scars heal nicely. If the scar is noticeable, it is in a location that few associate with breast augmentation. The transaxillary incision allows the implant to be placed above or below the muscle.

Since this incision is away from the breast, it is very important to find a surgeon who is well trained in this procedure. In the event of a complication, you will need another surgery and most likely from a different entry point. The transaxillary incision may not be suitable for certain types of corrective surgery. As an example, if you suffer from bottoming out, where the implant has dropped in the breast pocket below the nipple (giving the nipple the appearance of being too high) an incision on or under the breast would be more suitable.

Nipple Area (Periareolar) Incision

The Periareolar incision is located on the nipple itself. It is the most common incision for women receiving mastopexy (breast lift). It works well with every type of implant and for over and under the muscle placement.

The Periareolar incision is made around the bottom half of the areola (the dark circle of skin surrounding the nipple). For the scar to blend properly the surgeon must cut exactly on the edge where the lighter skin meets the darker skin. If the incision occurs within the darker area, a "smiley face" scar can form from the lighter-colored scar tissue. Surgical tape is placed on the incision to reduce the effects of gravity pulling on the skin. The scar usually heals as a flat, thin line. If the incision is properly p erformed and the healing directions given by the surgeon are followed carefully, the scar is almost invisible.

A periareolar incision carries the risk of infection from the need to cut into the breast ducts. Bacteria exist in the breast ducts and can spread germs into the pocket holding the implants. Many surgeons use a protective sleeve between the implants and the breast ducts. This sleeve is only useable in implants that can be placed into position while unfilled.

This is only the beginning of the many things you need to discuss with your surgeon. Trusting your surgeon's opinion is crucial. There is no single answer that works for everyone. It is always best to seek the advice of an experienced plastic surgeon before settling into any decision. Contact our office and we'll help you find your best options.