Answer: There are several different possible incision locations for breast enlargement. The incision may be made around the nipple, in the crease beneath the breast, or in the armpit. Some surgeons also perform a trans umbilical technique whereby saline implants can be inserted through an incision made in the belly button. During consultation, we will discuss all of your options and the advantages and disadvantages of each.

Answer: The location of the incisional approach for breast augmentation is determined by patient and surgeon preference, the type and size of implants used and the possible need for a combined breast lift. If a breast lift or mastopexy will be performed with the augmentation, then the mastopexy incisions can be used for placing the implants. If not, the standard approaches include incisions in the fold beneath the breast, at the lower border of the areola, or in the axilla. In general, the incision in the fold beneath the breast is the safest and most versatile approach. The risks of hematoma, infection, capsular contracture, loss of nipple sensation, implant rupture and implant malposition all should be slightly lower with this approach compared to the others. Any secondary procedures to address early or late complications could also be performed through this same incision, avoiding additional scars. Otherwise, the peri-areolar and axillary approaches are acceptable alternatives in almost all cases. The length of these incisions can be more limited than with the inframammary approach. When placing silicone gel implants, which are completely filled when inserted, a longer incision may be necessary or preferred than what is possible with these approaches. In fact, it may be impossible to insert a larger gel implant through an axillary or peri-areolar incision, or at least to do so without damaging the implant. There are some newly developed devices such as the Keller funnel which can facilitate safe insertion of gel implants through smaller incisions.