There are several options available when choosing an incision for breast augmentation. Typically, a plastic surgeon will use an incision that he or she is most comfortable with. Additionally, the type of implant chosen by the patient and surgeon, silicone or saline, will impact the choice of incision. The most common incisions performed in Detroit, Michigan, are the inframammary fold, periareolar incision, transaxillary approach, and transumbilical approach.

Inframammary Incision – Of the choices, the most common incision is the inframammary approach. This incision is the most versatile and all types of breast implants can be inserted through this incision. It offers optimal visualization when performing breast augmentation. It also heals very well, eventually leaving an imperceptible scar that falls in a natural skin fold. Any acute complications can be managed through an inframammary incision, and although infrequent, revisions are also more precisely performed through this incision.

Periareolar Incision – The primary benefit of the periareolar incision is possibly the less visible if it heals very nicely. However, there is a slightly higher incidence of changes in nipple sensation, and the incision needs to be accurately closed to avoid irregular breast tissue under the incision. There is also a limit to the size of silicone implant that can be placed through a periareolar incision.

Transaxillary Incision – The transaxillary approach is a blind procedure, meaning that the surgeon cannot visualize the interior of the pocket while developing the implant pocket. Using specially-designed instruments, the surgeon can observe externally as the pocket is developed. There may be a higher risk of implant malposition because of this lack of visualization. There may be a higher instance of bleeding as well. Any acute complications, including bleeding or infection, are not as efficiently dealt with using this approach. There is also a limit to the size of silicone implant. The primary advantage of this incision is there is no incision on the breast itself. The incision is made in the natural fold of the armpit, where a channel is created to insert the implant.

Transumbilical Approach – This approach is placing an implant through the belly button. This incision is one of the least used since it doesn’t offer any significant advantage over the other incisions. Additionally, it is not widely popular or accepted with most board-certified plastic surgeons.

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