The type of incision used in a breast implant surgery are determined by several factors; most commonly patient preference, surgeon preference, and implant type.
There are four locations on the body where incision can be made:
- the sub mammary, or the breast crease
- the areola, or lower nipple area
- the axillary, or the armpit
- the transumbical, or navel
The sub mammary incision is the most commonly preferred incision by certified plastic surgeons while the transumbical incision is less common.
The Sub Mammary Incision
The sub mammary, or breast crease, incision is the most common incision for several reasons. It is the preferred method when using the most common implant: the cohesive implant with textured surface. Also, scars in the breast crease are less visible due to modern measurement techniques.
Many consider the sub mammary incision to be the safest method as well. Implants can be placed above or below the pectoral muscle from this site and an incision there does not affect the mammary gland. Also, this site gives the surgeon a complete view of the surgical area to safely complete the procedure.
A common concern with breast implant surgery is obvious scarring. With the sub mammary incision, scarring is minimal and rarely noticeable when proper care is taken during post-surgery. (See this article on post-surgery care.)
The Areola Incision
The areola incision is made on the lower part of the nipple and is mostly used for sub-glandular implants, which places the implant in the mammary gland above the muscle. Though an effective surgery location for many, there are more risks to consider than with the sub mammary incision.
Recipients of this incision have increased risk in loss of feeling in the nipple and risk difficulty breastfeeding. Scarring is also more visible with this incision because it is a more noticeable location.
The Axillary Incision
The axillary incision in the armpit is somewhat controversial in point of safety. Some surgeons believe incision here has an increased risk of infection due to bacteria in the armpit hair while others believe the risk to be the same as is commonly associated with implant surgery. Also, many feel there is a more limited view of the surgical field in this location.
Other complaints with this method are that the implants end up higher on the chest. Scar-tissue in the armpit can pull the implant upward, causing them to look unnatural. There is, however, minimal, almost unnoticeable scarring in this location. The axillary incision is not recommended for high profile breast implants.
The Transumbical Incision
Because the incision is in the navel, the transumbical incision does not leave a visible scar. The implant must be placed outside the pectoral muscle, which carries a risk of asymmetrical implants that may not be fixable. Also, once made, this incision site cannot be reused and any additional procedures must be done through a sub mammary or areola incision.
Only saline implants can be used through the navel. These risks and limitations make the transumbical incision the most unlikely choice for breast implant surgery.
There are advantages and disadvantages to each incision type. Consider your options and meet with your surgeon to discuss your hopes and concerns. Then, he or she can determine the best incision for your needs.