Breast Augmentation Incisions FAQs

This section covers frequently asked questions (FAQ) about breast augmentation incisions, including their location, and their advantages and disadvantages. If you have a suggestion for any additional questions, let us know.

How many types of breast implant incisions are there?
Which breast augmentation incision is best?
How long will my incision be?
I am getting a breast lift, can my lift incisions be used to insert my breast implants?
My bra is hurting my breast augmentation incision lines, what can I do?
Why do some surgeons make large breast implant incisions compared to some endoscopic incisions I have seen?
Is it true transumbilical breast augmentation (TUBA) has a reduced chance of staph infection? What about the other breast implant incisions?
How long does it take for breast implant scars to fade in all the incision placements? Do some areas heal better than others?
Will my surgeon use permanent, nondissolvable, or dissolvable incisions for my breast augmentation incision lines?
What are Steri-Strips™? or surgi-tape? Why do some surgeons use them and some don't?
Can't my surgeon use fibrin tissue sealant (tissue glue) on my incisions?
I just had my sutures removed and my incision line is opening back up. How can I tell if I have an infection?
My surgeon gave me two sets of incisions, periareolar and inframammary. He said it was to help him situate the breast implants correctly. But my friends don't have two sets. What gives?
How long do I have to wait to use scar remedies on my incision lines?
I want to go larger (or need a revision) can my surgeon use my old breast implant incisions?
Is the transumbilical breast augmentation incision really scarless?
I form keloids. Which breast augmentation incision is best for me?
If I start to develop hypertrophic scarring what can be done about it?

1. How many types of breast implant incisions are there?

There are four basic locations for incisions in breast augmentation surgery:

Inframammary: also known as a crease incision, since it is located in the inframammary crease below each breast.
Transaxillary: also known as the armpit incision. This augmentation surgery is performed endoscopically.
Periareolar: also known as the nipple incision. The incision is not actually on the nipple but around the edge of the areola, the dark area around the nipple. This incision is done endoscopically and usually results in a small, undetectable scar unless you do not scar well. The incision can be above, on either side, or at the lower edge of the areola.
Transumbilical: known as TUBA, for transumbilical breast augmentation. This involves an incision within the navel. The surgery is done endoscopically.

If you are having an abdominoplasty (tummy tuck) at the same time as breast implantation, it is possible to have your breast implants inserted through your abdominoplasty incision. Similarly, if you are having a breast lift. The surgeon may use the incisions for that procedure.

2. Which breast augmentation incision is best?

There is no one best incision, since it depends on factors like what kind of breast implants you are getting, your anatomy, your lifestyle, what size implants you are getting, and your surgeon’s preferences. To some extent, it is up to you. Don’t choose your surgeon based on breast augmentation incision alone. There are surgeons who will insist that one is better than the other, and each type of incision has its group of fans. It all depends upon your needs. Remember, you will end up with bigger breasts no matter what incision is used, but some will give you less scarring than others.

3. How long will my breast augmentation incision be?

The length of your breast augmentation incision depends on the placement, implant surface, and implant type and size. The skin on the abdomen is more elastic than the breasts and slightly more elastic than the underarm. That is why transumbilical breast augmentation incisions are very small, and underarm and breast incisions about the same. Incisions for breast augmentation can be anywhere from 1 to 4 inch.

Understandably, a larger breast implant requires a larger incision. A textured implant may need a very slightly larger incision than a smooth implant. Prefilled breast implants need larger incisions than saline breast implants that can be filled after they are in place.

4. I am getting a breast lift. Can my lift incisions be used to insert my breast implants?

Yes. If you are having a breast lift (mastopexy) no additional incision is usually made and implants are put in through the lift incisions. Breast implants can also be put in through the incisions for an abdominoplasty (tummy tuck), if your surgeon agrees that it is appropriate.

5. My bra is hurting my breast augmentation incision lines. What can I do?

If your incisions have closed, you can either wear an elastic bandage (ACE is one brand) around your breasts and then wear the bra on top, or use foam padding like EpIfoam™ from BioDermis.com.

6. Why do some surgeons use large breast implant incisions compared to some endoscopic incisions I have seen?

Not all surgeons are going to give you the same options. This is just a fact of life. Some surgeons use the same technique and breast implant incisions they have been using for years. Some do so because they honestly believe it is better and some just haven’t bothered to learn anything new. This is one reason to have consultations with several qualified surgeons. All surgeons are not created equally.

7. Is it true that transumbilical breast augmentation (TUBA) has a reduced chance of staph infection? What about the other breast implant incisions?

Some surgeons have found that the chances of a staph infection are reduced if breast implants are put in transumbilically compared to incisions on the breast, particularly periareolar incisions. This may be because periareolar breast implants are passed through the milk ducts, where staph bacteria are found naturally. It is also thought that in the event of an infection of the incision area, the incision in TUBA is far from the implant pocket, reducing the necessity of implant removal. If an infection is present in the implant pockets, you will more than likely need removal and antibiotic treatment, and have to wait at least 3 months to be reimplanted.

8. How long does it take for breast implant scars to fade in all the incision placements? Do some areas heal better than others?

Scar formation depends on the individual. Different people heal and form scars at different rates. However, for most people, the maturation of breast implant scars usually takes 10 to 12 months. The scar will look its worst after about 3 months, when it is red and raised. It will then begin to fade usually to a slightly lighter color than your normal skin tone. A scar has only about 80% the strength of unaltered, undamaged skin. This can account for stretching or thinning of breast implant incisions.

9. Will my surgeon use permanent or dissolvable incisions for my breast augmentation incision lines?

This depends on your surgeon's technique of choice and what procedures will be performed. With standard breast augmentation procedures, sutures are usually nondissolvable type and are removed 7 to 10 days after surgery. The larger the breast augmentation incision and the larger the implant, the longer sutures may need to remain. If you are having a breast lift (mastopexy)or are having an areolae reduction, your surgeon may use permanent sutures that stay in place. Ask your surgeon what type of sutures will be used and why.

10. What are Steri-Strips™ or surgi-tape? Why do some surgeons use them and some don't?

Steri-Strip™ Skin Closure is a product made by 3M, while surgi-tape is a generic term for medical paper adhesive tapes. These tapes cover your incisions and assist in the flattening and fading of breast implant scars. Many surgeons believe that they can significantly help produce minimal scarring. They can be left in place for long periods of time (assuming you have no allergy to adhesives) and are used for a number of surgical procedures.

Some surgeons use sutures within the tissue and cover the incision with Steri-Strip, which results in an almost nonexistent scar for many patients. But not all use them. Remember, all surgeons are going to be different and although I advocate the use of Steri-Strips™, your surgeon may not.

11. Can't my surgeon use fibrin tissue sealant (tissue glue) on my incisions?

Fibrin and other tissue glues are often used in face lift and other surgeries. Some breast surgeons do use it for breast augmentation and breast lifts. Tissue glue usually stays on the skin for 2 weeks or more. It seals off blood vessels so there is no excessive bleeding and keeps the skin together, reducing or eliminating the need for sutures.

You will find that not all surgeons are sold on fibrin or tissue glue for various reasons. Speak to your surgeon for his opinion on the matter.

12. I just had my sutures removed and my breast augmentation incision line is opening back up. How can I tell if I have an infection?

If your breast augmentation incision line is reopening, you need to tell your surgeon immediately. This can happen because of infection, rejection of the implant, poor circulation, or other problems. If you have an infection, you may see fluid weeping from the incision line and it may have an unpleasant odor. It is possible to weep clear fluid without there being an infection present. However, the longer you go with the incision open, the higher your chances are in getting an infection.

Sometimes, the wound edges do not adhere correctly due to compromised vascularization that can happen if you have poor circulation and especially if you smoke. The edges of the incision may need to be trimmed and resutured. But the most important thing is to call your surgeon if your incision is opening up.

13. My surgeon gave me two sets of incisions, periareolar and inframammary. He said it was to help him place and situate the breast implants correctly. But my friends don't have two sets. What gives?

This happens when the surgeon is either inexperienced or is faced with an unusual case due to your anatomy. More often, it is because the surgeon is inexperienced. The majority of surgeons can insert, position, and fill breast implants through one single scar in the navel or two standard incision placements and do not need four. Before your surgery, find out how many breast implant incisions you will have. You may choose one type of incision, but may also be asked to choose an alternate incision placement in the event there are problems. However, an experienced surgeon is well practiced in the placement of breast implants through one or two standard incisions. You deserve an explanation if this is the case.

14. How long do I have to wait to use scar remedies on my incision lines?

You have to wait until the incision is closed. Do not use anything unsterile on your breast augmentation incision until then or you could risk an infection. Ask your surgeon this question and follow his or her instructions.

15. I want to go larger (or need a revision) can my surgeon use my old breast implant incisions?

Yes. There is usually no need to have additional breast implant incisions if you are having removal/replacement with no lift.

16. Is the transumbilical breast augmentation really scarless?

Using a transumbilical breast augmentation is often considered scarless, but in reality, the scar is hidden within the navel. There is no visible scar.

17. I form keloids. Which breast augmentation incision is best for me?

Keloids are lumpy fibrous tissue that forms at the site of incisions or injuries. You should definitely tell your surgeon that you are prone to form keloids. You surgeon will probably choose to insert the breast implants through your armpit or your navel. If neither of these choices is possible, you probably should use a scar remedy product afterwards such as silicone sheeting since it has been shown to prevent keloids and hypertrophic scarring. Talk with your surgeon about this before you use anything.

18. If I start to develop hypertrophic scarring what can be done about it?

Silicone sheeting has been shown to help prevent and lessen the appearance of keloid and hypertrophic scarring. Several of the women at Yes, They’re Fake! have used the silicone sheeting from Biodermis with success. The company makes the sheeting in shapes and sizes that are specific to breast augmentation surgery.