Breast Augmentation Incision Options

An important issue to discuss with your plastic surgeon before breast augmentation is the placement of incisions. All incisions placement options are designed to conceal as much scarring as possible from view. But each incision option still comes with its own set benefits and disadvantages. To ensure optimal results, a little pre-op investigation is warranted.

The four main types of breast augmentation incisions are the inframammary (breast crease incision), peri-areolar (nipple incision), transaxillary (armpit incision), and TUBA (navel incision), with the two most common being the inframammary and the peri-areolar.

Inframmary Incision: positioned in the crease below the breast, inframmary incisions can be used for any of the three implant placement options, subglandular (over the chest muscle), partial submuscular (upper 2/3 of implant under chest muscle), and complete submuscular (entire implant under chest muscle). This incision option allows the surgeon the best visibility and control over implant placement during surgery. Revision surgery is also easiest to perform using the original incision when the inframmary option is used.

Peri-areolar Incision: one of the two most commonly used incision options, the peri-areolar incision follows the edge of the areola, the dark area of the skin surrounding the nipple. This technique allows for all three implant placement options and offers the surgeon great visibility and control of the breast area during surgery. For those combining a breast lift with their augmentation, the peri-areolar option will be used since a nipple incision is needed in all breast lift procedures.

Transaxillary Incision: offering the advantage of well-hidden scars in the natural creases of the armpit, transaxillary incisions are commonly used in endoscopic procedures. This incision option requires greater skill than the inframmary and peri-areolar options, so be sure to choose a surgeon familiar with this technique if a transaxillary incision is important to you. Many women like the hidden scar offered by this option, however, if revision surgery is needed, a new incision will be needed which will result in additional scarring. Though implants can be placed in all three positions using this technique, the implants are being placed far from the incision site. Therefore, your results may not be optimal unless a skilled surgeon is used.

TUBA: TUBA stands for trans-umbilical breast augmentation, and uses a belly button incision. Also known as the "scarless breast augmentation", TUBA incisions are nearly undetectable. Though more and more surgeons are learning and performing this technique, it is not nearly as common as other breast augmentation procedures. Before undergoing a TUBA breast augmentation, it's important to choose a surgeon with the skill to properly perform it. Due to the great distance from the incision to the breast area, the surgeon has less control of the implant placement using this technique. Though both subglandular and partial-submuscular implant placement can be performed using the TUBA technique, finding a surgeon able to perform the submuscular technique may take some looking.

Though some scarring is inevitable with all types of surgery, even cosmetic surgery, careful placement of the incisions combined with advanced wound care techniques can make scars less noticeable. For more information on incision options for breast augmentation, St. Louis plastic surgeon and his staff will be happy to answer your questions.