There are several incisions used for this procedure. The most common incision used for breast augmentation is still the inframammary crease incision and is made under the breast mound in the crease or fold of the breast and chest wall. The advantage to this incision is it offers very good access to the implant pocket regardless of whether the pocket is above or below the pectoralis muscle and is quick direct access for any additional procedures which may be necessary in the future such as capsulectomy or capsulorhaphy (manipulating or removing the capsule that forms around the breast implant). The disadvantage to this scar is that it may be noticeable if the patient doesn’t have a well defined crease under her breast or when lying down.
The peri-areolar incision is another very popular incision for breast augmentation and is made between the colored portion of the areola and the adjacent skin. This scar is in the most conspicuous place; but most often is barely perceptible because the scar is camouflaged due to placement within the existing natural color change of the areola. This incision also allows excellent access to the implant pocket and for any revisions of the capsule in the future. There has been speculation that this incision may have higher incidence of injury to the nerves of the nipple/areola. This is not necessarily true if the local plastic surgeon does not go through the breast gland, but instead tunnels around it in the subcutaneous plane as previously mentioned. Another potential disadvantage is increased risk of infection as the nipple ducts can harbor bacteria which may contaminate the cosmetic surgery field. This method has an advantage for the release of inferior breast gland tissues from the skin envelope which can sometimes aid in slightly lifting the breast in certain cases where minor breast sagging occurs but isn’t severe enough to require a full breast lift surgery (mastopexy).
