Approaches (Scar Location) in Breast Augmentation
The scar on your skin after breast augmentation fades over time. Dr. Laverson applies advanced plastic surgical planning and techniques to conceal your scar for the least possible visibility. Location of your scar is determined by the opening created for insertion of your implants. The three most popular scar locations are at the rim of your areola (periareolar), along the crease at the bottom of your breasts (inframammary), and in your armpit (transaxillary). There is no best scar location for everyone, each location has advantages and disadvantages. Some women prefer one scar location over the other based on swimsuit styles they like, or other considerations. For many women, either approach is suitable. If you are among them, Dr. Laverson will leave the decision entirely to you. Our most common approach is inframammary (beneath the breast), but Dr. Laverson has also operated through the areola and armpit for many patients with excellent results.
If your areola is very small, Dr. Laverson prefers to avoid it. Large implants can be particularly difficult to insert through a small areola. If you plan future pregnancies and/or nursing, this may be another reason to avoid the areola. If your areola has a poorly defined or irregular border that may not conceal a scar well, it is preferable to choose another approach. If nipple sensation is important to you for sexual stimulation, Dr. Laverson avoids the areola. Additionally, capsular contracture may be more likely if the implant is placed by the areola approach. Bacteria living within breast ducts are more likely to seed the implant pocket when these ducts are opened during surgery. The largest ducts are near the areola, and are undisturbed by other approaches.
If the inframammary crease is poorly defined, asymmetric, or must be lowered an indeterminate amount to achieve a good result, the areola or armpit may be preferred. If a peri-areolar breast lift is to be performed with the augmentation, there is no need for an additional scar, so the periarolar approach is preferred. Large, darkly pigmented areola skin and a well defined areola border that will conceal a scar well also favor the areola approach. If uncertain whether or not breast lift (mastopexy) is necessary, the areola approach may be recommended.
An armpit scar (transaxillary) is furthest away from the breast, but breast re-shaping over the implant is more difficult to accomplish from further distance. Placing larger sized implants through the armpit can be technically challenging, and shaped implants are more difficult to perfectly orient through the armpit (transaxillary) approach. Women who frequently shave their armpit may want to avoid an axillary scar until it is well healed and flat.
Many women are not happy with the shape of their breasts, or have asymmetric breasts (right and left breasts are different sizes), inverted nipples, and other problems that can be improved with special techniques. The normally shaped breast is a round or elliptical soft mound with sensuous curves and a pigmented areola centrally located with the nipple projecting above the level of surrounding areola. This robust, appealing, youthful breast contour, symmetrically sized on right and left, is the goal of most breast procedures, regardless of the starting point. The possibility of achieving beautiful breasts is affected by your anatomy, available implants, the size and location of scars necessary to fix existing problems, and other factors.