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          Breast Implant Incision Patterns: Fast Facts

          • Incision Patterns

            Incisions, decisions... choosing the type of breast implant and its size is only part of the breast augmentation decision process. There's a virtual laundry list of choices you will be asked to make with the guidance of your plastic surgeon. This can be stressful and emotional for many women.

            The location and pattern of the incision is one of the most important of these choices. It will depend on your surgeon's preference or training, your body, your goals, your propensity to scar, and the type and size of your breast implants. For example, only saline-filled breast implants can be placed via a transumbilical incision (TUBA).

            Here are some fast facts on the four breast augmentation incision patterns.

          • Inframammary Incisions

            Incision Patterns - Inframammary

            Inframammary or crease incisions are made in the crease below each breast. Once an incision is made, the surgeon creates the pocket either under or over your chest muscle. The scar from an inframammary incision is often small (one to one and a half inches wide) because smooth, saline breast implants, which can be inserted via tiny incisions, can be used with this type of incision. (By contrast, textured or silicone gel-filled implants need slightly longer incisions that may not be ideal if you tend to develop raised, red scars.) The main advantage of this type of incision is that it puts the surgeon close to the breast, allowing for better visibility and more precise implant placement.

          • Periareolar Incisions

            Incision Patterns - Periareolar

            A periareolar incision is made between the areola (the pink or brownish skin that surrounds your nipple) and the regular skin of your breasts. The areola tends to be darker, which means scars can be camouflaged. Risks include a small chance of decreased, transient nipple sensation. This incision pattern may also increase the chances that you have difficulty breast-feeding.

            Another possible complication is staph infection, as staph bacteria can be found in the milk ducts of the nipple, and these ducts may be cut during the procedure.

          • Transaxillary (Armpit) Incision

            Incision Patterns - Transaxillary

            Breast implants can also be inserted through incisions in the armpits (transaxillary incisions). This may be done with an endoscope (flexible tube with a small camera on the end of it). Transaxillary incisions run between one and one and a half inches long, depending on the type of implant. Some surgeons consider this to be the best incision pattern for full submuscular placement. This is also considered a good choice if you want to breastfeed, as it is less likely to damage the milk ducts compared with other incision patterns. The main downside is that the incision site can only be accessed once, so any revision breast surgery would require a different route.

          • The Transumbilical Breast Augmentation (TUBA) Incision

            Incision Patterns - Transumbilical

            The transumbilical breast augmentation (TUBA) incision is "scarless" because the scars from the J- or C-shaped incision are hidden within the confines of your belly button.

            TUBA is performed using an endoscope (flexible tube with a small camera on the end of it). After making the incision, the surgeon inserts tiny instruments through two tunnels that lead to the areas under the breasts, then creates two pockets using tissue expanders — silicone shells similar to breast implants that are inflated to create the pocket and then removed. Using this technique, breast implants can be placed either under or over the chest muscle.

            Besides the fact that it is scarless, TUBA also confers a lower risk of infection, is a shorter surgery and promises a quicker recovery than with other breast augmentation incision patterns.

          • Next Steps

            Incision Patterns - Next Steps

            Now that you have been schooled on the basics, you are more prepared for your consultation. Remember to ask your surgeon which incision pattern he or she recommends for you and why. Always let the breast surgeon know if you are planning to breastfeed and whether you tend to develop raised red scars. These two insights can help tip the scale toward one type of incision over another.

            Find a breast augmentation surgeon near you now, or learn more about your breast implant options.

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            Joseph A. Mele, MD, FACS

            130 La Casa Via
            Building 2, Suite 206
            Walnut Creek, CA 94598
            (925) 943-6353
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          • 95 Scripps Drive
            Sacramento, CA 95825
            (916) 929-1833

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            Charles Lee, MD

            Enhance Medical Center
            462 N Linden Dr
            Beverly Hills, CA 90212
            (877) 868-1772
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