Breast augmentation is the second most frequent surgery in cosmetic plastic surgery after liposuction. Over time, the methods used have evolved offering maximum results with minimum complications.

In order to avoid excesses, it is now necessary for the plastic surgeon to calculate your dimensions (height, weight, breast volume and the perimeters of your hips and chest) and suggest your personal ideal type and size of breast implant and design the surgery plan. Read (How to Choose the Best Breast Implant Size and Shape for Your Body Type.)

The 4 Types of Incisions Used With Breast Implants

The incision can be made either under the breast, which is only 1.6-2 inches long (inframammary incision), either at the edge of the nipple (periareolar incision), in the armpit area (transaxillary incision) or through the belly button (transumbilical). Yet, the most popular approach remains the inframammary incision, as it seems to offer more benefits both for the plastic surgeon and the patient.

Inframammary Incision

The Benefits

  • Greater surgical vision and control.
  • Low scar visibility.
  • Breastfeeding glands remain unaffected.
  • Nipple sensitivity unaffected.
  • Breast's natural fall covers any scarring.
  • No implant type restrictions.
  • Many options for breast implant placement.
  • Longevity.
  • Quick recovery time.
  • Lower risk for capsular contracture.

Greater surgical vision and control

The inframammary crease is the point where the lower part of the breast meets the chest wall and forms a natural fold. With the inframammary approach, the plastic surgeon has greater visibility and control of the surgical site and the adjacent structures during the operation.

Therefore, he or she can immediately examine the point where the implant will be inserted, offering him excellent surgical precision. The plastic surgeon makes an incision of about 1.6-2 inches, depending on the type and the size of the implant, which, as it heals, decreases in length.

Low scar visibility

The only case where the incision is visible is when you are lying on your back naked. Still, this only happens during the first few months after surgery, as the scar slowly gets the color of the skin and gradually fades out.

It is important the incision to be made in the new, future inframammary fold, that is where the new inframammary crease will be located after the introduction of the implant.

Breastfeeding

It is true that, nowadays, the majority of the breast augmentation surgeries are performed through the inframammary incision. One of the advantages of this approach is that the glands of the breast that produce the milk during breastfeeding are not affected. Yet, if the implants are placed on top of the muscle, it may put extra pressure on the ducts and glands, which could decrease milk production functionality.

Nipple sensitivity

The same thing applies to the sensation of the nipple, too. It is very difficult for the nerves to be affected during the procedure due to the distance between the incision and the nerve. In addition, if complications occur and additional plastic surgery is required, the initial incision may be used.

Natural fall

Over time, this approach has the benefit that the natural fall of the breast will completely cover the scar. In those who have no children or are very thin, the scar may be more prominent, but it will still be completely covered by the bra or the bikini top.

No implant type restrictions

Plus, there are no restrictions regarding the type of implant you can use, as both saline and silicone implants can be placed through the inframammary incision. Even the size of the implant that you may choose should not bother you since the plastic surgeon can adjust the incision to accommodate smaller or larger implants accordingly.

Many options for breast implant placement

In addition, the inframammary incision offers many alternatives regarding the placement of breast implants. The plastic surgeon can choose to insert them either above the chest muscle, partially below the chest muscle, or completely below the chest muscle. In the case where the implant is fully covered by the muscle on the lower pole of the breast, you cannot feel it under the skin, when you touch your breast.

Longevity

Another advantage of placing the implant completely under the muscle is that over the years the implant is held in its original position without bottoming out and your cleavage remains full.

In other words, if the muscle is not stitched to the lower pole, with a special technique that the plastic surgeon uses in order to cover and support the implant when you will be standing, the implant will be palpable. Yet, this is something that cannot be detected in photographs, or when someone just sees your breast without touching it.

Quick recovery time

Plus, when it comes to operation and recovery time, they are much shorter with the inframammary approach compared to the other ones. (Read Breast Reduction: 7 Tips for Fast Recovery and Minimal Scarring.)

Lower risk for capsular contracture

Last but not least, the inframammary incision is reported to demonstrate significantly lower risk for capsular contracture.

Therefore, as it is expected, the many advantages of the inframammary incision make it a popular choice not only among patients but among plastic surgeons, as well.

The Disadvantage of the Inframammary Incision

One drawback to inframammary approach from a cosmetic point of view is that it makes it difficult for patients to change their breast size later on. If you wish for a larger size, the new implants can make the scar move up. On the contrary, if you want a breast reduction, the scar can move down so it will be visible below the crease of the breast.

For those who initially have very small breasts or little-to-no natural breast fold, the plastic surgeon may also find it difficult to place the incision in the ideal position. However, you can avoid such risk by always consulting an experienced, board-certified plastic surgeon. (Read Choosing Your Plastic Surgeon: 10 Tips For Your Next Cosmetic Procedure.)

What We've Learned

Breast augmentation is designed to improve your appearance and boost your self-confidence, it is rational that you would like the surgical scar not to be visible post-operatively.

Although the incision is inevitable, with the improvement of breast augmentation techniques, the scar is minimized to such an extent that it is practically unnoticeable.

It goes without saying that a qualified plastic surgeon has to inform you about the different methods available and the various sites where the incision can be made, and together you will choose the technique that best fits your body, type of implant and your lifestyle.