Incision Options for Breast Augmentation

There are many variables to navigate when considering breast augmentation surgery: an implant’s size, shape, and contents are all common discussion points for patients and their doctors. However, it’s equally important to understand the different types of incisions that can be made for the surgery, as well as their risks and implications. For patients in the Washington, DC area who are looking at their cosmetic surgery options for breast augmentation, we offer the following information.

Saline vs. Silicone

Before deciding on the site of your incisions, it’s important to decide whether your implants will comprise saline or silicone. Each substance carries its own advantages and disadvantages, along with a recommended method of surgery.

• Saline: Because saline implants tend to be filled after insertion, they may be rolled up beforehand and inserted through a smaller incision. Disadvantages of saline implants include their tendency to look and feel less natural than silicone. For larger augmentations, there is also an increased risk of downward displacement due to the implant’s weight.
• Silicone: Silicone implants are generally chosen for their more natural appearance and texture. Silicone is also lighter than saline, resulting in a lower rate of displacement, rippling, and wrinkling. These implants are pre-filled, resulting in incisions that must accommodate their size and placement.

Types of Incisions

Prior to the augmentation, you will discuss the best method of implant insertion with your surgeon. Although your preference will be taken into account, the location of the incision also depends on your body type, breast size, and implant type. Before discussing your options, familiarize yourself with the four types of breast implant incisions: 

• Inframammary: This is the most popular type of incision, performed near the crease between the breast’s underside and the body. The length of the incision can vary as needed, and can be re-opened in the event of revision surgery. Like periareolar incisions, this location allows the surgeon to easily position the implant, and scarring can be easily concealed by most undergarments or swimwear.
• Periareolar: This incision is made around the edge of the nipple. Its location allows for accurate placement of the implant, while minimizing visible scarring. This incision is relatively small, and therefore most surgeons reserve it for saline implants that are filled after insertion or for smaller sized silicone implants. For two to five percent of patients, this may result in a loss of sensation in the nipple.
• Transaxillary: The incision is performed at the patient’s underarm, leaving no visible scarring near the breasts. Because of the distant location, implants may be more difficult to place. Additionally, this incision may not be re-opened for any revision surgeries.
• TUBA: A TUBA (trans-umbilical breast augmentation) incision is made at the navel. This incision is smaller, less noticeable, and heals faster than other incision locations. In return, there is greater room for error with this technique, and it may only be used in conjunction with inflatable saline implants. TUBA incisions are best reserved for surgeons with experience and specialization in the technique.

Considering Breast Augmentation?

If you’re considering breast augmentation, contact our office for an informative consultation on your options. Dr. Rassael will help you determine the type of implants and surgical techniques that will yield you the best looking, safest results. We welcome your inquiries and concerns about any of our services.