What Is the Difference Between Implant Incisions?

Posted on March 10, 2016 by: Dr. Ronald DeMars

Many patients come to our office knowing what incision they want for a breast augmentation, usually based on the experience of one or more friends that have breast implants. Though it is not unusual for a woman to want more information about the different incision options.

There are four basic incisions and they are:

  • On the lower edge of the areola
  • In the fold below the breast
  • In the armpit
  • Through the belly button

The incision through the belly button is almost never used anymore and will not be discussed further as it is applicable only to saline implants. Today, over 95 percent of patients now choose the silicone implant for their surgery.

The areola incision is quite predictable in how it will heal and it varies from a faint white line to invisible — so it is a very good choice from the cosmetic standpoint. Even if it is a faint white line it is covered even in the smallest of swimsuits and can even be hidden by medically tattooing an areola color of ink into the scar. It is not the best choice for a larger breast because of the long tunnel that must be created to get to the space behind the breast tissue and muscle where the implant must be placed. Some patients, however, have an aversion to an incision in this location.

The incision in the fold below the breast, often called the IMF or inframammary fold, is the most popular incision both with patients and surgeons. The scar is hidden in the fold and most often is a very faint white line and in a place where the patient can’t see it and technically it can be used for any patient no matter the size or shape of the breast.

The armpit incision waxes and wanes in its popularity. The obvious benefit is the very hidden nature of the scar but there are limitations in the size of silicone implant that can be introduced through this location because those implants come prefilled. Saline implants come empty and are filled by the surgeon once inside the patient so this limitation is not applicable to the saline devices. There have been some papers published in the medical literature in the last few years that indicate the infection rate may be a little higher with the armpit incision.

Regarding breast implant incisions, we often receive questions about how each may affect recovery, nipple sensitivity or the ability to breast feed. In all three incisions the postoperative pain and recovery are about the same as is the small risk of temporary or permanent loss of nipple sensitivity, and none of the incisions have been shown to cause loss of the ability to breast feed.

If you have more questions for Dr. DeMars about incisions for breast augmentations, please contact our office online or at (503) 253-3458. We are happy to set up a consultation to have Dr. DeMars help you determine which option is the best for you.