The placement of the breast augmentation incision is based upon three factors: Dr. O’Grady’s preference to achieve the surgical goals, which incision traverses and traumatizes the least amount of tissue, and patient preference.
There is no single incision that is perfect for every patient. Each has its own advantages and disadvantages. Factors which influence incision placement include: scar visibility, operative exposure, potential to injure vital structures including nerves, disruption of breast tissue, access for revision procedures, pre-operative breast size and type and size of implant.
Infra-mammary Fold Incision for Breast Augmentation
The most common placement of scar is the infra-mammary fold (IMF) incision, which is in the breast fold at the base of the breast. It offers the best exposure and operative control, least disruption of breast tissue and risk to vital structures. Its main disadvantage is that is leaves the most visible scar.
Peri-Areolar Incision for Breast Augmentation
The peri-areolar incision is located at the edge of the areola from the 3 o’clock position to the 9 o’clock position. If offers very good exposure with a more camouflaged scar than the IMF incision. Disadvantages include increased exposure of the implant to breast bacteria, altered nipple sensation and limited access size to place larger implants.
Axillary Incision for Breast Augmentation
The axillary incision is located in the armpit. It offers absolutely no scar on the breast itself and no violation of breast tissue at the implants are slid in underneath the pectoralis major muscle. However, visualization is very poor and the technique is done mainly by feel. This can be improved with an endoscope, but this adds cost and time to the procedure. Access to the lower part of the breast is poor and revision surgery is difficult. As well, there is a greater chance of injuring some of the nerves that supply the breast. Furthermore, only saline implants can be placed through this incision. On rare occasions, a very small cohesive gel implant can be placed, but this is indeed very rare.
Dr. O’Grady has performed surgery on patients using all three of these incisions. He can help determine which is the best incision for you.