Your Breast Augmentation Incision Options Explained

Breast augmentation can be a customizable procedure, and patients can choose from options such as implant type, implant shape, and implant placement. Many patients considering breast augmentation are surprised to learn that they also have options for incision type.

Your incision options will vary depending on your anatomy, implant choice and cosmetic goals. To help you understand the differences, the following guide explains some of the most common breast augmentation incisions.

Areolar Incision

The areolar incision is made along the lower edge of the areola, which is the pigmented tissue surrounding the nipple. The location of this incision along the areola border makes the resultant scar well-camouflaged. Also it allows for precise implant placement because the implant pocket can be completely visualized during surgery. The incision can be used again if the patient decides to have revision breast surgery in the future.

The areolar incision is ideal when using saline implants because they can be inserted when empty and then filled once they’re in the implant pocket. Silicone gel implants may also be used depending on their size and the size of the patient’s areolas. This incision allows implants to be placed either behind the breast tissue or under the chest muscle.

Inframammary Incision

The inframammary incision is made in the crease between the breast and the chest wall. Patients find this incision to be an attractive option because the scar is easily concealed on the underside of the breast. It also offers direct visualization of the implant pocket during surgery, which allows for precise implant placement.

Both saline and silicone implants can be used with the inframammary incision. This incision is associated with low rates of capsular contracture, and it can be reused in most breast revision procedures.

Axillary Incision

This incision is made in the armpit, and then a direct channel is made to the implant pocket in the breast. The surgeon creates the pocket with the assistance of an endoscope, which is a type of lighted surgical telescope. The axillary incision leaves the breast unscarred. With this method, the implants are nearly always placed behind the chest muscle.

This incision can be used with saline and silicone gel implants, as long as the gels are not overly large. This incision often cannot be reused if the patient subsequently requires revision breast surgery.

How Do I Know Which Incision Is Right for Me?

Your initial consultation for a breast augmentation will help you and your surgeon determine which incision is right for you. During your consultation, your surgeon will conduct a physical examination of your breasts. Based on your anatomy and your cosmetic goals from breast augmentation, you will be provided with recommendations about which incision would best suit your needs.

Some women choose to undergo breast augmentation with a lift for optimal breast rejuvenation. If you plan on undergoing breast augmentation with a lift, your incision options will be different from those used in breast augmentation alone. In either case, your surgeon will help you determine which incision would be most appropriate.

Other Factors to Consider About Incisions

Surgical Techniques

Advancements in breast augmentation surgery make it possible to shorten incision length in some cases. Silicone implants traditionally required a longer incision, but the Keller funnel device allows the surgeon to insert implants through a shorter incision. The Keller funnel also reduces trauma to the incision. Both of these factors can significantly reduce the appearance of resultant scars. This technique is also known to decrease the risk of infection, and may reduce the risk of capsular contracture   .


The ability to breastfeed is a concern for some women considering breast augmentation. The ability to breastfeed largely depends on the degree to which the breast ducts are disturbed during surgery. Fortunately most women who have breast implants can breastfeed after their surgery. If you do plan on breastfeeding in the future, it’s important to discuss this with Dr. Pugash so that he can create a treatment plan based on your specific needs.

When it comes to breast augmentation, patients have many options to choose from to fully customize their surgery. To explore the surgical possibilities of breast enhancement, contact plastic surgeon Dr. Eric Pugash to schedule your personal consultation.