The Breast Implant Incision Decision

What are my incision options for breast implants?

Every decision you face when you embark on a boobie journey ultimately depends on your boobie goals. Basically, what you desire your breasts to look like after your breast augmentation.

And one of the decisions is which surgical site the breast implants are placed. Let's refer to this as your Incision Decision!

The Breast Implant Incision Decision

There are essentially four incisions that can be made to place a breast implant:

  • The Inframammary fold (IMF) - aka 'underboob' or 'crease' or 'in the fold' incision

  • The Peri-areolar incision - aka 'nipple' incision

  • The Trans-axillary - aka 'armpit' incision

  • The Trans-umbilical - aka 'belly button' or 'navel' incision

Breast implant incisions locations

There's also a fifth option that applies if you're having a breast lift (mastopexy) performed at the same time as implant placement... and that's using the incisions created during the lift surgery (so, you don't need one of the four breast augmentation incisions as well).

How you choose which of these is right for you depends on other factors, like the type of breast implant (silicone or saline) and the location of the implant (under or over the muscle).

Underboob Breast Implant Incision

This is the incision site most women choose.

It's good for: placing silicone or saline implants, women with tuberous or sagging breasts, and a hidden scar.

It's a good choice for both plastic surgeon and patient as it gives the surgeon a great deal of precision during the operation (as they can see what they're doing) and this type of scar (once it's faded) can be fairly well hidden in the fold of your breast.

Should I chose an Underboob Breast Implant Incision?

It's also a good choice for reducing the risk of capsular contracture as there is less chance of bacteria getting in to the breast during surgery.

The size of the incision can be as small as 3cm but is usually about 5cm. The size depends on your plastic surgeon's skill and the type of breast implant being placed. So, for example, an anatomical (aka 'teardop' or 'shaped') breast implant (which is a bit firmer than a round implant) will require a slightly wider incision.

The downsides to an IMF incision is the potential to see the scar when you're lying flat (but this doesn't bother most women) and it can be hard to get the scar positioned well in women with small, tight breasts.

Nipple Breast Implant Incision

A nipple incision is made (usually) along the lower edge of the nipple where it meets the skin of your breast.

Nipple Breast Implant Incision

It's not used as commonly now as it was in the 80's and 90's because implants placed via the nipple require that the breast tissue be cut on the way to where the breast implant goes. Nonetheless, there are some great plastic surgeons who use this primarily (and do it well).

It's good for: placing saline implants, women with tuberous or sagging breasts, and a hidden scar.

The downsides to a nipple incision are that this is a sensitive area so nerves (and therefore sensation) can be disrupted, you can introduce bacteria to the breast (increased risk of capsular contracture), it won't work well if you have small nipples, and potential problems with future breastfeeding are higher.

Armpit Breast Implant Incision

If you're absolutely determined that you don't want a scar on your breast, the armpit incision may be right for you.

It's good for: placing saline implants and no scar on the breast.

BUT if you're going for a 'no scar show' you might want to think how often you show your armpits. Most people show their armpits more often than their breasts! So the scars here can be more visible, not less visible.

The downsides to an armpit incision are that there is a slightly higher risk of the implants ending up slightly out of position (because the incision is far away from the surgery site). This may also not be the best incision site if you're having dual plane (under the muscle) placement, or you're opting for large silicone implants.

Belly Button Breast Implant Incision

Way before I even started to seriously think about my first breast augmentation I read about breast implants placed by a belly button incision and I remember thinking "That sounds amazing!". Two breast surgeries and a fair few years later I'm a little bit more level-headed about a belly button incision site for a BA.

It's good for: placing saline implants and no scar on the breast.

Belly Button Breast Implant Incision

You will find some plastic surgeons offer this is an incision site option, but most surgeons don't do it.

That's because it has a fairly major downside: the surgeon cannot see what is being done. An open incision creates a scar but it gives the plastic surgeon something which is key to breast surgery... visbility.

An umbilical incision involves putting an instrument through a cut in the belly button and moving it (with blunt dissection - i.e. cutting) all the way up to where the the implant is going to be placed.

Only saline breast implants can be placed this way as there's only space to move an implant shell via the instrument into the breast (where it is then inflated with saline).

Don't worry too much about it, beautiful results can be achieved with each incision type. Because there are pros and cons to each type, the best way to reach the right decision for you is to talk through your goals with a Board Certified plastic surgeon. They will know which breast implant incision decision will get you to your boobie goals! :)

Thoughts from Dr. Glenn Davis

The incision location is a part of every consultation and there are reasons to use each site. Except the belly button. There is no reason to use the belly button.