Incision types used for the placement of breast implants during breast enlargement

Periareolar or inframammary breast implant insertion

The most common incisions are those in the outside of the areola (the darker area surrounding the nipple, not the nipple itself) (called “periareolar”) or just above the fold of the underside of the breast (called inframammary). Both above the muscle and submuscular implants can be done this way, as can explantations of implants being replaced. Most doctors will agree that the best placement of the implant with the most consistency can be achieved through these traditional incisions.

The obvious disadvantages of these methods are more visible scars on the breast itself, potentially more trauma during surgery and longer and more painful recovery in some cases than incisions in either the navel or armpit. For most, the nipple incision seems to be hardly noticeable unless one has a tendency to scar badly. I had to have a surgery through the nipple once and have virtually no visible scar.

Navel (transumbilical or TUBA [Trans Umbilical Breast Augmentation]) insertion of breast implants

An incision is made in the navel and an endoscope is passed up just below the skin to the area where the implant will be placed whether under or over the muscle, as in other implant surgeries. The endoscope is connected to a television and the doctor can watch on the monitor where he is placing the implant. Some doctors claim there is a risk of poor placement this way. Recovery can be much shorter this way because there are no stitches near the arms and breast and less healing of scars and internal tissue that would be cut to pass through the areola or inframammary area.

Risks include having to make a normal breast incision if the placement is not working out during surgery and the fact that most surgeons will not be able to consistently get as good results this way as if they were working through an incision right on the breast. I did not see it as a risk because the possibility of having no scars at all was worth the try. If it did not work out, then I would have scars like the other methods. You can also get subcutaneous emphysema which sounds a lot worse than it is. It means air trapped under the skin temporarily. It works its way out but can feel a little weird. I did not have this problem.

Breast Augmentation through armpit (axillary or transaxillary) incision

This method involves an incision in each armpit and also uses the endoscopic method of placement. This method is used primarily for those who don’t want scars on the breast and who don’t wish to have the surgery done through the navel. The benefits again are no visible scars on the breast. Disadvantages include the fact that there is a scar in the armpit which may be visible in sleeveless clothing.

Increased or diminished sensation, according to most surgeons, is related not to the type of incision used but the care of the surgeon in not disturbing the nerves which lead to the nipple area. All of the incisions have a risk of diminished sensation.

Next Stop: Shapes of breast implants