FAQs: Breast Augmentation Incision Locations for Breast Implants

Incision Types &  Locations for Breast Augmentation - Which is best for me?

Inframammary Incision - Breast Implants

The inframammary incision is made just above the fold of the underside of the breast (called inframammary fold or crease) and is arguably the most common incision used. Both above the muscle and submuscular implants can be done this way, as can explantations of implants being replaced. So many surgeons prefer this method because proper implant placement is most important and surgeons have the most control in most cases with this incision. The obvious disadvantage of this method is visible scar and longer and more painful recovery in some cases than other incision types.

Periaerealor (also known as the Areola Incision) - Breast Implants

This incision is placed outside of the areola (the darker area surrounding the nipple, not the nipple itself). Implants can be placed both above the muscle and below the muscle with this incision and implants can also be explanted through this incision if implants are removed and replaced. The advantages of this method are that the scar tends to heal well. The disadvantage is that there is a higher risk of exposure to the natural bacteria that is found in the breast tissue. One other obvious disadvantage is that the scar is located directly on the breast. If a patient does not heal well it will be visible. However most women say their scars have healed well. Finally, although a peri-areolar incision does not necessary cause any greater amount of risk of sensation loss than other incisions, women with smaller areolar areas may be subject to a greater loss of sensation if it is necessary for the incision to extend beyond the areola. As with the inframammary incision, doctors have a great amount of control over implant placement with the areolar incision.
Note: "peri" often implies "around" the areola. Most often, the surgeon will only make an incision around the lower half, or less, of the areolar margin unless a lift is being performed.

Navel (transumbilical or TUBA) Incision - Breast Implants

An incision is made in the navel and an endoscope is passed up just below the skin to the area where the implant will be placed whether under or over the muscle, as in other implant surgeries. The endoscope is connected to a television and the doctor can watch on the monitor where he is placing the implant. Benefits are no visible scar near the breast. Risks include having to make a different breast incision if the placement is not working out during surgery. Many doctors have claimed there is a risk of poor placement this way. Doctors who perform the TUBA claim that doctors critical of the TUBA incision are just not experienced in it. You must find a surgeon who specializes in this method. Most surgeons that do this method can only place the implants over the muscle. There are doctors who do perform this surgery with subpectoral placement but there are fewer such surgeons.

Armpit (axillary or transaxillary) Incision - Breast Implants

This method involves an incision in each armpit and also uses the endoscopic method (see above) of placement. This method is used primarily for those who do not want scars on the breast. The benefits again are no visible scars on the breast. The disadvantages to this are that there may be a noticeable scar in the armpit area. Many women say you cannot see it once it has healed. Other disadvantages include the incision being further away from where the doctor is working during surgery, as with the TUBA method above.

Benelli, Lollipop, Vertical, Anchor Incisions - Breast Lift with Breast Implants (Mastopexies)

These are incisions you'll need to know about if you're having a breast lift. A Benelli or the similar "pursestring" mastopexy is used when a woman has a small amount of sag. The incision is usually all the way around the areolar margin and the extra skin needed to be removed to effect the lift is pulled towards the nipple (like a pursestring) and then removed, being then sewn back to the areolar margin. This results in less flesh and a resulting lift.

lollipop or a vertical incision is required if you have a little more sag and tissue below the areola also needs to be removed to make the lift effective. You'll have a scar from the base of the areola downward, usually to your crease.

An anchor is the most invasive incision and is reserved for a breast lift that really amounts to a reduction. An incision is made from the base of the areola downward (usually in conjunction with a lollipop incision) and then at the base of the incision at the crease, also extends left and right from the vertical incision like an upside down "T".

Overall - Incisions & Breast Implants

Keep in mind that there is very little documentation to associate any particular incision with more or less risk of loss of nipple or other sensation. In fact, most doctors agree that loss of sensation has a lot more to do with implant size and surgical technique, both of which can dictate how large the area of insult to nerve endings will be inside the breast. Also, remember that there is no BEST incision. A very well healed incision in any location is better than a poor incision in any other location. What incision looks best depends on how it has healed and what position you are in, what you are wearing, at any given time. Your doctor should give you choices.

To see the incision site detail photos, follow the following links:
Areola pre-op and post areolar incision
Transaxillary incision

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