Printable Header
Procedures - Breast Augmentation
Breast Augmentation | Breast Lift | Augmentation & Breast Lift | Breast Reduction | Revisions | Special Cases | An Informed Decision | Instructions
Intro | Axillary | Breast Fold | Areolar | Choosing an Incision | Muscle Placement | Recovery Photos

Which Breast Augmentation Incision Is Best?

So which breast augmentation approach is best for you? This is a very personal decision, and mostly depends on the aesthetics you are trying to achieve. Some women prefer the breast fold or areolar scars because those are always hidden with clothing, even with a small bikini top. Other women choose the axillary approach to avoid scars on the breast that may be visible while looking at the breasts in a mirror or during intimate encounters. For the most part, beautiful results can be achieved with each incision and with low risks. So, we recommend that you make this decision mostly based on how you want to look and feel with your breast augmentation. To help you with this process, we have created the following table with a number of important advantages and disadvantages of each breast augmentation approach for you to consider:

Site of incision Advantages Disadvantages
Axillary Endoscopic
  1. No scar on the breast
  2. Scar often blends into skin crease well and is hard to detect
  3. Usually least visible of augmentation scars
  4. Endoscopic technique provides full visibility and precise surgical control of pocket creation, bleeding and implant placement
  1. A poor scar (which is not typical) may be visible in sleeveless tops
  2. Limited in treatment of some cases of mildly sagging or tuberous breasts.
  3. The longer (2-2.5 inches) scar needed for placement of silicone gel implants can be difficult to hide in small underarms.
  4. Large silicone gel implants cannot be placed through this approach.
  5. Additional surgery, such as removal of scar tissue from around the implant (capsulectomy), may be difficult with this approach.
  6. Very small risk of numbness of the skin around the underarm and upper arm.
  7. Risk of scar tissue band formation under the axillary scar. But, if this occurs it usually resolves spontaneously over time.
Breast Fold
  1. Direct visibility of pocket creation and implant positioning.
  2. In patients with deep folds, the scar is hidden by the breast.
  3. Good approach for additional breast surgery.
  4. Good approach for treatment of cases of mildly sagging or tuberous breasts.
  5. Excellent access for placement of silicone gel implants.
  1. Scar on the breast.
  2. Hard to hide scar on small, tight breasts, without deep folds.
  3. Scar may be visible when you are lying flat.
Areolar
  1. Direct visibility of pocket creation and implant positioning.
  2. Scar may be well hidden by areolar tissue.
  3. Good approach for additional breast surgery.
  4. Good approach for treatment of cases of mildly sagging or tuberous breasts
  1. Scar is often visible and is at the focal point of the breast.
  2. Most women do not want this sensitive area operated on.
  3. Exposes the implant to breast tissue and bacteria within the breast tissue. (However, increased risk of infection with this approach has not been scientifically proven).
  4. Some sensory nerves around the areola are cut. (However, increased risk of loss of nipple sensation with this approach has not been scientifically proven).
  5. Greatest risk of problems with future breast feeding.
Umbilical *

* Not performed by Dr. Connall and not approved by the implant manufacturers
  1. No scar on the breast
  1. Blind, blunt pocket creation
  2. Silicone gel implants cannot be placed though this approach
  3. Precise creation of pocket difficult
  4. Precise control of bleeding difficult
  5. Precise implant positioning difficult
Image 1
Image 2