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There are many approaches to incisions in breast augmentation, and this can be confusing for patients. In general, most surgeons favor one approach. While none of the incisional approaches are bad, some have disadvantages. I favor the inframammary incision. This places the incision in the crease of the breast. In my opinion, this incision enables the best positioning of the implant, provides a well hidden scar, and yields the most natural result. The inframmary incision is particularly good when placing silicone gel filled implants as these require a slightly larger incision than saline filled implants.

Placing the implant through the armpit (transaxillary approach) can lead to an unnatural or high-riding appearence. Placement of the incision around the nipple (periareolar approach) can lead to an unfavorable scar or distortion of the nipple.

You can view an educational video of the inframmamary approach at the link below:

Breast Augmentation: Inframammary Approach

Below is some information from Mentor on incisional approaches which is helpful in understanding the different surgical incisions which can be utilized.

What are the differences between incision site options?

There are three common incision sites used for breast augmentation: under the arm (transaxillary), around the nipple (periareolar), or within the breast fold (inframammary). Although the incision will be made as inconspicuously as possible, its length and appearance may vary depending on the type and size of implant, your body contours, and the surgeon�s preference.

Periareolar Incision

The periareolar incision is one of the most common incisions used in breast augmentation. A single small incision is usually placed along the perimeter of the areola. This incision is the most concealed, but is associated with a higher likelihood of inability to successfully breast feed, as compared to the other incision sites.


The inframammary incision is placed along the crease of the lower portion of the breast. A single, small incision is made along each breast. While this incision is less concealed than the periareolar, it is associated with less difficulty when breast-feeding.


The transaxillary incision is placed in the natural fold of the armpit; therefore there will be no scar on the breast. A small incision is made inside each armpit. The surgeon may use a probe fitted with a miniature camera, along with minimally invasive (very small) instruments, to create a pocket for the breast implant. While this incision is less concealed than the periareolar, it is associated with less difficulty than the periareolar incision site when breast feeding.

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