I get asked a lot about which incision is best for putting in breast implants. And the answer is, they all work, they just each have benefits and bad things that go with each one. The one in the armpit is probably the least common these days because silicone implants come prefilled and to shove a giant prefilled implant through that little incision totally destroys the lymphatics in the arm pit and that makes cancer treatment, cancer diagnosis – God forbid if you get that – much more difficult down the road. So a lot of people have stopped using that incision for gel implants.
The one around the nipple works very well. It hides and it’s always covered in clothes, but if you think about the mechanics of that, you make the incision in the front and then you have to go all the way through the breast tissue to get back behind it to make a pocket to put the implant in. That cuts through a lot of duct work, a lot of gland and it showers some bacteria into the incision and that has a little bit increased risk for capsular contracture, which is scar tissue that makes the implant feel hard.
The one underneath, nobody likes that one because it is on bare skin. You can see it. But it is easily the least painful and it has the lowest capsular contracture rate.
So, which one you pick, kind of falls into what risk are you willing to take for long-term versus, are you going to be OK with having an incision that is always covered in clothes? There’s no right or wrong choice. You just need to know the options, the pros and cons for each option, and then pick one that’s best for you.