Where are breast implant incisions made? There are four possible locations: the inframammary incision in the breast crease, the periareolar incision around the areola, the transaxillary incision in the armpit, and the transumbilical incision at the belly button. Most surgeons offer the first two, and the inframammary crease incision is the most common and often preferred.
The incision is one of the more personal decisions in a breast augmentation, since it affects your scar, your options, and even future surgery. Here’s a clear look at each incision option, with the advantages and trade-offs of all four.
Inframammary Incision (Breast Crease)
The inframammary incision is made in the crease under the breast, and it’s the preferred choice for many surgeons. It stays hidden in the breast crease and allows good exposure during surgery, which means better control of implant placement and bleeding. In most cases, once the implant settles, the scar actually sits just above the crease, so it isn’t visible in a bathing suit.
Periareolar Incision (Around the Areola)
The periareolar incision is placed where the areola meets the surrounding skin. When it heals well, this incision is nearly invisible, but if it heals poorly, it sits on the front of the breast where it’s more noticeable. It works for saline and silicone implants, though large silicone implants are hard to place through a small areola because of limits on incision length.
There is also a slightly higher risk of infection and capsular contracture with this approach, because the breast ducts contain bacteria and are often cut during surgery. Patients who are especially concerned about nipple sensation or future breastfeeding may prefer to avoid an incision around the areola.
Transaxillary Incision (Armpit)
The transaxillary incision is hidden in the armpit, entirely off the breast. It’s only useful for saline or small silicone implants, and it generally can’t be used for a second surgery, so you’d need a different incision if you ever have a revision or implant replacement. It may also interfere with testing the lymph nodes for breast cancer, because it can disrupt the normal flow of lymphatics from the breast to the armpit.
Transumbilical Incision (TUBA, Belly Button)
The transumbilical, or TUBA, method uses a small incision in the belly button to place the implant with a scope. This approach is only for saline implants and isn’t offered by most surgeons, because it provides limited visualization during surgery and the incision can’t be reused for any future procedure.
Which Incision Is Best?
There’s no single best incision for breast implants; the right choice depends on your implant type, your anatomy, your scarring, and your priorities around visibility and future surgery. For many patients, the inframammary crease incision offers the best balance of a hidden scar, excellent surgical control, and flexibility for any future revision, which is why it’s so commonly recommended.
The Bottom Line
So, where are the incisions made? In the breast crease, around the areola, in the armpit, or at the belly button, each with its own advantages and trade-offs for scarring, implant options, and future surgery. The best incision for you is a personal decision your surgeon can help you make based on your goals and anatomy.
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Frequently Asked Questions
Where are breast implant incisions made?
There are four possible sites: the inframammary incision in the breast crease, the periareolar incision around the areola, the transaxillary incision in the armpit, and the transumbilical incision at the belly button. Most surgeons use the crease or areola, with the inframammary being the most common.
What are the different types of breast implant incisions?
The four types are inframammary (breast crease), periareolar (around the areola), transaxillary (armpit), and transumbilical or TUBA (belly button). The crease and areola incisions are the most widely offered, while the armpit and belly-button routes are limited to saline or small silicone implants.
What is the best incision for breast implants?
There’s no universal best incision; it depends on your implant type, anatomy, and priorities. For many patients the inframammary crease incision is preferred because it hides the scar, gives the surgeon excellent control, and can be reused for future revision surgery, unlike the armpit or belly-button routes.
Which breast implant incision leaves the least visible scar?
Both the inframammary and periareolar incisions can heal to a nearly invisible scar. The crease scar hides in the fold and often settles just above the bikini line, while a well-healed areola scar blends into the color border, though it’s on the front of the breast if it heals poorly.
Does an areola incision affect nipple sensation or breastfeeding?
It can be a concern. Because the periareolar incision passes near the ducts and nerves around the nipple, patients who are especially worried about nipple sensation or future breastfeeding may prefer a different incision, such as the inframammary crease, to keep that area undisturbed.
Can every breast implant incision be used for revision surgery?
No. The inframammary and periareolar incisions can generally be reused for a revision or implant exchange, but the transaxillary (armpit) and transumbilical (belly button) approaches cannot, so you’d need a new incision for any future surgery if those were used originally.
This article is for general information only and is not a substitute for personalized medical advice. Always consult a qualified surgeon about your specific situation.