Guerra Plastic Surgery Center
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Breast Incisions

Learn the pros and cons of each incision type.

Breast augmentation incisions are made to be as inconspicuous as possible, usually under the breast, around the lower part of the nipple or the armpit. All breast augmentation skin incisions are noticeable, although some are less noticeable than others. Some patients are better candidates for one type of incision versus another, because of skin composition, texture and color. For good looking results, the vast majority of silicone gel breast implants are inserted via the crease under the breast incision. Certainly, a strong recommendation is made that all Contour Profile Gel (CPG) breast implants, such as, Mentor's MemoryShape breast implants be placed via the crease.

We highly recommend a consultation with Dr. Aldo Guerra to determine your options.

breast incision diagram
Under the breast incision lines.
breast crease incision diagram
Under the breast incision lines.

Under the Breast Crease Incisions

When the breast augmentation incision is made below the breast, in the crease, there are several advantages:

  1. Incisions placed in breast creases, when fully healed, will look like part of the crease, becoming almost invisible to the human eye. The principle of using a natural fold or crease on the body is used in many plastic surgery operations to help camouflage incisions as best as possible,
  2. this incision allows immediate access to the pectoral muscle for under the muscle breast implant placement. The surgeon can choose to place the breast implant either below or above the muscle creating less swelling and disturbance to the tissues. This results into a smoother and more comfortable recovery,
  3. normal breast tissue begins above the lower breast crease incision. An incision placed here allows for the most desirable anatomical placement of the breast implant. The ideal cleavage enhancement is typically achieved via the crease incision. The risks of the breast implant ending up too high in the chest, which gives patients an unnatural, operated-on look, are minimized,
  4. because the surgeon is closest to the breast using this incision, the plastic surgeon has greater control and command over the breast tissue. When the plastic surgeon has greater control, results are much more predictable.
before after
Actual patient, under the breast crease incisions.

Armpit Incisions

Armpit or transaxillary incisions start high on the lateral chest wall and extend through the tissues to reach the inferior breast crease and cleavage area. While some patients believe that this procedure results in augmentation without scars, in reality, this incision can be quite noticeable after breast surgery. In some patients, these incisions can prevent the individual from shaving the armpit area where the incision becomes tender. Additionally, because breast augmentation surgery starts at the greatest distance from the cleavage and the breast mound itself, results of transaxillary surgery is traditionally noteworthy for creating less than ideal cleavage. The ultimate location of the breast implant may also be more lateral, while the lengthy pathway of surgery may lead to more swelling and discomfort after surgery.

before after
Actual patient, armpit (transaxillary) incisions.
breast armpit incision diagram
Armpit (transaxillary) incision lines.
breast nipple incision diagram
Nipple incision lines.

Nipple Incisions

Nipple incisions are used in patients with a very distinct border between the nipple and the rest of the breast. In these patients, carefully placed incisions become almost invisible after the healing portion of the recovery is complete. After the nipple incision is made, a tunnel is created in the breast tissue down to the level of the breast muscle. At this point, your top plastic surgeon can choose to create a pocket either above the muscle or below the muscle to place the implant. Because the procedure involves surgery through the breast tissues, there is often more swelling when using this nipple incision.

before after
Actual patient, nipple incisions.

Actual patient, Embrace before and after 1 year photo

Embrace® Active Scar Defense

8 week scar therapy treatment

Embrace® Active Scar Defense is a NEW state-of-the-art treatment clinically proven to minimize the formation of scars after surgery. Dr. Aldo's delicate hand in surgery and the advanced Embrace® scar therapy treatment is a winning combination for beautiful results.

Make an appointment today with Dr. Aldo to discuss using Embrace® Active Scar Defense with Breast Augmentation.

Keller Funnel®

Proportional to your body.

The Keller Funnel® is considered state-of-the-art technology for the placement of silicone gel breast implants and was designed to ease the placement of MemoryShape® or MemoryGel® through standard breast augmentation incisions. The funnel is a simple device which gives a patient undergoing breast implant surgery significant advantages for achieving solid long-term results. For the plastic surgeon, the funnel provides 5 very important advantages when performing breast augmentation or breast lift with silicone gel breast implants:

  • Reduces local forces applied on the implant shell for better long-term results.
  • Reduces incision length with silicone gel breast implants.
  • Reduces trauma to the patient's breast tissue, improving recovery time.
  • Lessens breast surgery time and reduces physician fatigue.
  • Allows for a “no-touch” delivery which reduces the rate of capsular contracture.

Dr. Aldo is on the cutting edge of the latest state-of-the-art products for breast surgery and highly recommends patients choose to add the Keller Funnel® for a breast augmentation with silicone gel breast implants.

Explore more details on the the benefits of using the Keller Funnel®.

before after
Actual patient, the Keller Funnel® was used to deliver the High Profile silicon gel breast implants with under the breast crease incisions.
Keller Funnel photo
Keller Funnel® photo courtesy of Keller Medical, Inc.