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Are You Familiar With The 4 Types Of Breast Implant Incision Techniques For Augmentation ?

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By Jerome Edelstein, MD

If you have decided to undergo a breast augmentation, you will soon find yourself making a number of important choices, such as the implant’s size, shape, placement, and material. Patients often decide between various types of breast implant incisions as well.

While your final decision should ultimately be made in consultation with your plastic surgeon, the benefits and drawbacks of each technique are outlined below.

Inframammary Incision

Surgeons using the inframammary technique make an incision along the bottom of the breast, in the natural crease or fold. It is probably the most popular incision nowadays. This incision site provides the surgeon with great visibility. As a result, the placement is precise with minimal risk of asymmetry and no disruption of nipple ducts or function. It also has the lowest rate of capsular contracture (hardening of the breast). The disadvantage of this incision site, however, is the presence of a scar below the breast. While in most cases any resulting scarring will be hidden on the underside of the breast and covered by a bra or bikini top, it can sometimes be seen when the breast is lifted.

Trans-axillary Incision

The trans-axillary incision is made within the armpit’s natural fold, which requires a pathway to be created from the armpit to the breast in order to place the implant behind the nipple. To allow for greater visibility, an endoscope is often used by surgeons utilizing this technique. The benefit of this incision site is that there is no scarring on the breast itself and the incision is hidden within the crease of the armpit. However, due to the limited visibility this incision site provides the surgeon, there is a greater risk of asymmetry in the implant’s placement.

Peri Areolar Incision

The peri areolar technique involves making an incision around the areola, usually just at the bottom edge. The advantage of this method is that the incision is strategically placed between the darker areola and the surrounding skin, which makes it difficult to detect post-operatively. Those who have very small breasts with no visible crease underneath may prefer this route.  In addition, it enables the surgeon good control when placing the implant, which results in improved accuracy and symmetry.

However, it is estimated that 2-5% of patients who opt for this incision site experience a loss of nipple sensation, while 20% are not able to breast feed in the future, which makes this technique undesirable for many women.  In addition, there is a higher rate of the complication called capsular contracture (hardening of the breast).

TUBA Incision

A TUBA incision is made on the edge of the navel, which requires a pathway to be created beneath the skin from the belly button up to the breast. This technique is usually performed blindly, using a blunt instrument to open up the pocket, into which the implant will be placed.  This procedure does not pose the risk of scarring on the breast, which is an advantage for many women, however, since the surgeon does the surgery blindly, there is a high risk of malposition. In addition, only saline implants are used with this method.

The best way to determine the optimal incision site for your breast augmentation is through a consultation with your surgeon. Please contact our clinic today to schedule a meeting with one of our board certified plastic surgeons.

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