Breast Augmentation Incisions

Incisions

Breast Implants can be inserted via any of the above four routes. Naturally, there are pros and cons with each approach and our Surgeon will explain these to you in detail at your Consultation.

Essentially, the differences are as follows:

Advantages Disadvantages
Infra-Mammary
(incision in the fold under the breast)
The most popular choice with patients.

Provides unrestricted pocket visibility for the surgeon.

Any size implant can be inserted.

Drains are not necessary.

Any future revision surgery can be performed through the same scar.

Leaves a scar in the fold under the breast.

Although the scar should hide well in the fold when standing, it can be more visible when lying down.

Asian or brown skin has a higher risk of forming brown pigmented scars.

Pigmented , thick or keloid scars could mar the appearance of an otherwise beautiful result if you are prone to them.

Trans-Axillary
(via the armpit)
Scar is placed in an inconspicuous skin crease within the armpit.

No visible ‘tell-tale’ scar on or around the breast.

An option worthy of consideration for those with brown or Asian skin who may form brown pigmented scars, or those with a history of thick or keloid scars.

(Please note that the same type scars could still result, the only difference being that they would be hidden in the armpits rather than being more visible under or on the breasts).

Although any size fillable saline implant can be inserted via this route, the small incision does limit the size of a silicone implant.

Only round implants can be inserted via this route.

‘Tear-Drop’ (Anatomical) shaped implants of any make cannot be inserted via this route.

Polyurethane Foam-Covered Implants, whatever the shape (‘tear drop’ or round), cannot be inserted via this route.

Drains are always used – these are usually removed on the following day.

Any future revision surgery would likely need the infra-mammary route thereby creating a second scar.

Peri-Areolar
(half way around the edge of the areola i.e. the pigmented area around the nipple).
Scar can be less conspicuous than with the infra-mammary incision. The small incision limits this approach to small silicone implants or any size fillable saline implants.

The dissection could sever some of the milk ducts around the nipple and interfere with future breast-feeding.

It has also been suggested that this route may cause ‘seeding’ of the resident nipple duct bacteria into the implant pocket and thereby cause a pocket infection.

Not suitable for Polyurethane Foam-Covered implants.

Any future revision surgery would most likely need the infra-mammary route thus creating a second scar.

Trans-Umbilical
(through the navel)
Scar is very small and located well away from the breast. Not popular or commonly performed in Australia.

Only suitable for fillable saline implants.

Difficult to create an aesthetic and refined implant pocket from such a distant entry point.

The passage of the surgical instrument can leave grooves under the abdominal skin.

Any future revision surgery would need to be done through the infra-mammary route.

 

Frequently Asked Questions

Four different approaches exist. They are:

  1. Infra-Mammary (in the fold under your breast)
  2. Trans-Axillary (via the armpit)
  3. Peri-Areolar (along the edge of your areola)
  4. Trans-Umbilical (via the navel)

  • Infra-Mammary is the commonest approach, the advantages being that it allows excellent visualisation of the implant pocket and any size/shape of implant can be inserted via this route.
  • Trans-Axillary is ideal for those who do not want a scar anywhere on or under the breast. The smaller incision does limit the size of a silicone implant that can be inserted but inflatable saline implants of any size can still be inserted via this route.
  • Peri-Areolar is not a commonly requested approach. The small incision does limit the size of silicone implants that can be inserted but inflatable saline implants of any size can still be inserted via this route.
  • Trans-Umbilical, commonly called TUBA for short, is not at all popular in Australia mainly because only inflatable saline implants can be inserted, and saline implants are far less popular than silicone implants. As it is more difficult to create a beautiful breast shape when working so far away from the breast implant pocket, our Clinic does not offer the TUBA approach.

The only approach which is slightly more expensive is Trans-Axillary. Infra-Mammary and Peri-Areolar have the same standard Surgical Fee. Our Clinic does not perform the Trans-Umbilical technique.
The main reason patients request the Trans-Axillary approach is to avoid any scar on or under the breast which could mar an otherwise beautiful result. This is especially important in those with Asian or brown skin because of their higher risk that the surgical scars could end up permanently pigmented. Admittedly, the same pigmented scars could occur in the armpit but at least in that location they would be hidden within a skin crease and not under or on the breast.

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