Which incision is best?
Breast implants can be placed either through an incision in the armpit, under the breast, or around the lower edge of the areola (Figure 11 – legend: A typical axillary incision is shown on the left, an areolar incision in the middle, and a breast crease incision on the right). An incision around the navel is also an option. However it is extremely challenging to place implants under the muscle with this approach and it is the least popular option.
Incisions can be as short as an inch for saline implants to an inch and a half for silicone implants. As mentioned previously, an armpit (axillary) incision can be used only for saline implants because silicone implants will not pass through the long and narrow channel between the incision and the breast. Saline implants will because they are put in empty and filled once they are in place. The axillary incision is an excellent choice for those who choose saline implants. Women who choose silicone implants are limited to using either an incision around the bottom edge of the areola or one that is under the breast. When the areolar diameter is too small an incision under the breast is the only choice available. Women with severely deflated breasts following multiple pregnancies are usually better suited to an incision placed under the breast. Areolar incisions in this particular type of patient will sometimes heal with a dent because the atrophic breast tissue cannot adequately resist the forces of wound contraction in the incision.