The breast implant incision or scar location after breast augmentation is a focus point of many patients’ prior to their consultation. Regardless of where the incision is made, there will always be a scar, as no surgeon can perform scarless surgery. Dr. Feldman is always amazed, when competitors have promised that. The three approaches each have positives and negatives. You should consider all three when determining the best incision for breast augmentation.
Infraareolar (under the nipple) incisions are associated with a higher risk of implant infection, higher risk of capsular contracture and could interfere with breastfeeding, as some of the breast tissue and duct work is disrupted. Counterintuitively, it is not associated with higher chance of numbness. It is not commonly requested in the US, but is very popular in Central and South America.
Transaxillary (armpit) incisions are also associated with a higher risk of implant infection and higher risk of capsular contracture. Additionally, it’s hot and humid in Texas for much of the year, so if you wear a tank top, sundress or bikini and lift your arm, in my opinion, you are far more likely to casually show this scar than the other two options. Third, you can have numbness or persistent ingrown hairs which can be bothersome if you shave your armpits. Last, but most importantly, is that breast implants placed through the armpit tend to “ride high” as the implant can be placed under the muscle, but if the muscle ends above the bottom of the breast it traps the implant in a less than pleasing position. This results in native breast tissue falling off the front of the implant or a “snoopy deformity.” A true dual plane cannot be created through the armpit. So it’s not a question of if Dr. Feldman can put an implant through your armpit, but whether or not it will ultimately yield the best result.
Inframammary (under the breast/in breast crease) incisions have the overall lowest complication rate, and Dr. Feldman believes yield the prettiest results, among the most common chest/breast anatomy in his practice. That’s a win-win situation, with a lower chance of complications and higher likelihood of the best result, which is why it’s the most common way Dr. Feldman places implants and the most common way implants are placed in the US. The incision is small, 4-4.5cm, or about 1.5 inches long, and is hidden by the crease and shadow your breast now creates. It will mature and fade over 6-12 months, but will never disappear.
Ultimately, the size, shape, cleavage and nipple position are the metrics that you will use to assess your result after breast augmentation surgery. If you have a “pretty” result, the incisions will mature and fade and are not an issue for the overwhelmingly majority of augmentation patients’. So at your consult Dr. Feldman will focus on how to deliver the most reliable, pleasing and pretty results.