If you’re considering having a breast augmentation procedure, you’ll already realise that there’s going to be potential for scarring at the incision site where the implants need to be inserted into the breast pocket. But what incision site options do you have? And when it comes to potential visible scars, which of these incision sites are least likely to bother you on a daily basis? In this short article and video, I cover this question I’m asked often during patient consultations.
What will my scars look like after a breast augmentation operation?
It really depends on what was required at the time of your procedure. If it’s a straightforward breast augmentation or if a lift was required at the same time.
Traditionally the scars are situated in three possible locations. One would be underneath the breast crease, second, around the areola or around the nipple, and third under your armpits.
Breast crease incision
In my practice I would say that majority of my patients would have their implants inserted underneath the crease, and the reason for that is that the scars are generally quite well hidden in the crease area of the breast, and you don’t often see them because it’s well hidden inside a bra, even in a bikini for example, if you were to visit the beach.
It’s normally around four to five centimetres long, depending on the size of the implant that we insert, and it allows for quite an adequate muscle release if your implants were going in underneath the muscle so that the top part of the muscle is covering the implant and the bottom half of the muscle is actually released off the chest wall, giving the opportunity for the implant to exert its maximum projective force on your breast tissue.
The second way of inserting an implant would be through an incision around the areola complex. This is less common because it is actually going to give you a more obvious scar that you will see permanently. And the areola and nipple area is actually not very clean and sterile, and so there is a higher risk of bacterial contamination when we are inserting an implant or doing an operation through that field.
The third way, which is through the armpit, is not an approach that I would routinely take with any of my patients, and there are some cons related to this incision site. Scars are a lot more obvious in the armpit region, especially if you were to go to the beach and wear anything sleeveless or be in a bikini. You’ve now got two scars underneath your armpits that people will see.
Not only that but the ability to release the under surface of the muscle where it’s attached to the chest wall is severely hindered by the fact that the incision is now further away from the bottom half of the muscle where we are trying to release.
Because of that the implant size that we are able to choose would then be limited as well, so that patients can only choose a smaller range of implants.
Future surgery scars
We general would say to a patient that once they’ve had their breast augmentation surgery, they would be up for maintaining their breast implant and may require revision surgery down the track. A lot of these revision surgeries at around the ten-to-13-year mark down the track will require incisions on the breast itself, potentially around the nipple maybe down into a vertical component and potentially into the crease.
And that is one of the biggest reasons as to why incisions in the crease to begin with or around the Areola to begin with is attractive because we could utilise those previous scars to do the revision surgery. But that’s not the case if you’ve had your scars in the armpit to begin with, we’re then going to need to make brand new scars on the breast where you didn’t have them before. And now you’ve got two separate scars to deal with.
So, as you can tell, it can be quite different depending on which approach we choose in the initial operative phase.
What about for augmentations with a lift?
This all changes unfortunately if you are going to need a lift as part of your breast augmentation procedure, and commonly that might require a scar around the nipple, plus or minus a scar in the vertical component and down into what we would call an inverted T or an anchor scar. It really ends up depending on how much loose skin we have to deal with at the time of surgery and how much breast tissue we’ve got to manoeuvre, and, as with all surgery, can greatly differ between each individual patient.