Breast Implant Incisions

During surgery, an incision will be made in either the crease of the breast, around the nipple or in your armpit. After the implant is inserted, the incision site is then sutured up with stitches that either dissolve or need to be removed by your surgeon a few days after surgery.

“Most of my patients correlate the soreness and heaviness to what it feels like when your milk comes in after having a baby,” says Concord, CA, plastic surgeon Eric Mariotti, MD. In most cases, you’ll be able to return home the same day as your surgery, but it’s best to have someone take care of you during your recovery period. “I recommend taking it easy for at least the first week,” says Grand Rapids, MI, plastic surgeon Dennis Hammond, MD, who also adds that it’s important to massage your breasts every day for the first six weeks after surgery. “This keeps the breast soft and reduces the incidence of capsular contracture. But you can only massage implants that are round,” he says. Before you begin massaging your breasts post-surgery, talk to your plastic surgeon about when to start massaging and how to properly do it.

When it comes to breast enhancement surgery, there are both incision and placement options that you can choose from, regardless of the shape or type of implant you settle on. Despite the type of incision you and your doctor decide is right, it should be made small enough so that once you are completely healed, ideally only a very faint scar exists. Scarring varies significantly from patient to patient and depends on many factors including genetics.

1. In the crease of the breast – Inframammary

• The Upside: Most plastic surgeons agree that an incision placed in the crease of the breast is the best method for providing symmetry. Also, if you ever need revision surgery in the future, your doctor can use your existing scar instead of having to make a new one.
• The Downside: Your scar may be more visible
• What the Expert Says: “This is the most commonly used incision because it’s the easiest way to get the implant placed,” says Dr. Dennis Hammond.

1. Around the nipple – Periareolar

• The Upside: Many surgeons and patients prefer this incision since it heals the best and the incisions are small. And once you are all healed, your scar should be virtually undetectable.
• The Downside: Some women, especially those with a very small areola, may not be appropriate candidates for this incision. There may also be scarring of some of the breast ducts, which could interfere with breastfeeding, although most patients can adequately breastfeed after undergoing surgery with this incision.
• What the Expert Says: “I have always felt that this incision provides the highest percentage of ‘good’ scars because there is an opportunity for the scar to blend with the color of the areola. Even if you heal poorly, this part of the body is not typically exposed,” says Bakersfield, CA, plastic surgeon Edmund Fisher, MD.

1. Through the armpit – Axillary

• The Upside: This option is best if you’re looking to be virtually scar-free on and around the breast.
• The Downside: Placing an implant through the armpit can be difficult since it’s hard to squeeze it in. If revision surgery is needed, your surgeon will need to make a secondary incision in order to remove or replace your implant.
• What the Expert Says: “It’s essential that an endoscope is used so that the placement of the implant is exactly within the pocket, otherwise you run the risk of the implant sitting too high,” says New York plastic surgeon Tracy Pfeifer, MD.