As I explain to breast augmentation patients at my Boston plastic surgery practice, the three incision sites for breast augmentation are transaxillary, inframammary and periarteriolar. Each will be discussed in turn.
Transaxillary incision sites are located in the armpit (axillary area) thus breast implants are inserted through the armpit and via a channel created by the surgeon into the breast. This requires no incisions to be made in the breast tissue and thus no scars are visible on the breasts. This technique has little effect on breastfeeding in the future.
Inframammary incision sites are the most widely used sites for breast implants. With these incisions the implant can be positioned by the surgeon either over, partially under or entirely beneath the chest wall muscle. The resultant scar on the breast should only be identifiable when the patient is horizontal thus scar appearance is usually minimal. The inframammary incision technique is advantageous in that if further breast surgery is needed then unlike the transaxillary method, a new incision is not required.
Peri-areolar incisions are located at the margins of the areola, the area of darkened skin surrounding the nipple. Similar to the inframammary incision techniques, periarteriolar incisions allow the breast implant to be inserted over, partially under or entirely under the chest muscle. The resulting scar is small and tends to heal well thus further minimising the scar appearance. Also with periarteriolar incisions, a new incision is not required with further surgery.
Each of the incision locations has their own advantages and disadvantages and thus it is largely patient preference that decides upon which is most suitable.