Choosing the best incision for a breast augmentation

by Dr. Steven Wallach

So which is the best incision for a breast augmentation?  The most common approaches are using an incision in the breast fold( inframammary), along the border of the areola ( periareolar), or through the armpit ( transaxillary).  each incision has advantages and disadvantages.  The most commonly used one is the inframammary approach.  It affords direct access and is hidden in the fold. Revisions and secondary procedures such as capsule adjustments and the like are often approached through this incision.  The periareolar approach is also popular. It is a direct approach and some secondary procedures can be performed through this approach as well. The periareola incision may not be used in patients with small areola diameters and who desire large implants.  The transaxillary approach is a remote access incision, and is often not used for secondary or revision procedures.  Commonly an endoscope is used for this approach. Like the periarolar incision, large silicone implants may be difficult to place via the transaxillary approach.  All in all, there are many approaches to place implants, and all have positives and negatives.  My patients are active decision makers in the process, and that is the way it should be!