Scars from breast implantation are typically located in 4 areas: in the breast fold (IMF), around the areolar, in the armpit (axillary) and in the umbilicus. Of these, the trans-umbilical route has been largely abandoned by most plastic surgeons today due to its limitations.
In my practice, I find the incision through the lower breast fold most versatile, allowing for the most precise placement of the implant, particularly if you want it below the muscle and not just below the breast. It is also the incision of choice in revision surgeries. I typically use a 3cm incision for tear drop implants below 300cc and 3.5cm for tear drop implants above 300cc. For smooth round implants, I am able to use a 2.5cm incision for less than 300cc and 3cm for above 300cc.
I do not typically use the areolar or the armpit incisions. I find the areolar incision has a higher risk of contamination from bacteria colonising the nipple ducts and also a greater risk of nipple numbness. Armpit incisions tend to be longer due to the further distance from the breast and also harder to hide, particularly if you favour sleeveless tops or are in swimwear.
I hope this answers your question!
Best Regards,
Dr Samuel Ho
