How Bad are the Scars from a Breast Augmentation?

Hi Doctors,

I'm in the process of researching having a breast augmentation procedure and I'm curious how bad are the scars from a breast augmentation? Are there certain breast augmentation methods that result in smaller scars? What would you recommend? 

Thank you very much. 

CTGirl

F, 26, Connecticut

Dear CTGirl, 

Love your name! In any discussion of plastic surgery, scars almost inevitably come up. We are surgeons, not magicians, and when we operate, we leave scars. The trick is to make them as small and inconspicuous as possible. To do this, we have a few tricks up our collective sleeves. One is meticulous handling of the skin and soft tissues. Another is the use of fine sutures and removing them as quickly as possible. Yet another is hiding our scars in natural lines and along anatomical units to make them less visible. For breast augmentation, there are four possible locations for incisions. The most ridiculous is in the belly button. Breast augmentation can be done through that incision and, yes, it leaves no scar on the breast but is makes an easy operation very difficult, is limited to saline implants, and is technically difficult and limited. Why anyone would choose to do this is a mystery to me. Less than 1% of breast augmentations are done this way. I think it is a marketing gimmick. The next is in the armpit. This also avoids a scar on the breast but has problems. Positioning of the implant can be difficult. It is hard to control bleeding if this occurs. Suffice it to say that even the surgeon who pioneered this approach no longer uses it. The next is an incision around the edge of the areola. I don't like this. The nipple and areola are the aesthetic focal point of the breast; these are what draw your eye to a breast. Any scar here, not matter how fine, will likely be visible. This position is also more prone to causing loss of feeling in the nipple area and may affect breast feeding. The most popular incision is in the crease under the breast. This has several things to commend it. It makes for easy access to creating the pocket for the implant. It is well hidden and inconspicuous. Poor quality scars are extremely uncommon- I have never had to revise a scar here in over twenty seven years of practice. If saline implants are used, the scar may be no more than 2.5-3 cm (1 inch) long. An incision of 2-3 inches is needed for silicone breast implants. This incision is the only approach for inserting silicone gel implants. The incision under the breast is the only one that is practical to re-use in the event that future work is needed on the augmented breast. 

Scar therapy can be used to help insure the best possible quality scar but no surgeon or technique can guarantee this. That said, problems with scars under the breasts are few and far between. 

Hope this helps!

Sincerely, 

Richard T. Bosshardt, MD, FACS

Thank you for the question. Breast augmentation scars can be very small and imperceptible with the passage of time.

Some scar placements are on the areola and some are in the armpit.

Discuss this with your plastic surgeon to choose the right one for you. 

Good luck!

Dr. Khuthaila 

https://drkhuthaila.com/Procedures/Breast/Breast-Augmentation-New-York-NY

Dr. Dana Khuthaila has 15 Breast Augmentation before & afters:

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The scar from a breast augmentation is rarely a problem.  The most common site for the incision in the US is in the crease under the breast.  This approach has the lowest chance of problems and is the most straightforward way to perform the procedure.  The scar is very inconspicuous.  I use a special funnel for placing the implants which results in an even shorter scar.  Best of luck.

Incisions for breast augmentation are usually discrete and in most cases very difficult to see once they have healed. They can be hidden under the breast fold or around the border of the areola.  Or, you can avoid placing any scars on the breast completely and hide the incision unde the arm or in the belly button. You can  get good results with all of them. You just have to find which one works best for you.    

Dr. Adam Hamawy has 2 Breast augmentation (Silicone breast implants) before & afters:

Breast augmentation (Silicone breast implants) before image performed by Dr. Adam HamawyBreast augmentation (Silicone breast implants) after image performed by Dr. Adam HamawyBreast augmentation (Silicone breast implants) before image performed by Dr. Adam HamawyBreast augmentation (Silicone breast implants) after image performed by Dr. Adam Hamawy

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Always best to be examined in person by a private practice boarded Plastic Surgeon/s in your area/city/state. If you are a scar former than this could add to our resultant scarring? I recommend either circumareolar or inframammary incisions as the better options. Regards Dr Darryl J Blinski in Miami IG: drfixitmiami

Dr. Darryl Blinski has 1 Breast Augmentation before & after:

Breast Augmentation before image performed by Dr. Darryl BlinskiBreast Augmentation after image performed by Dr. Darryl Blinski

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Hi-

   There are a few different options for incision placement with breast augmentation and in general all heal very well. The incision type are underneath the breast in the fold, around the areola, or in the armpit. The incisions are usually 3-4 cm in length. I prefer the incision underneath the breast because it gives the best direct access to the breast pocket and is hidden on the under surface of the breast. Good Luck!

We have found the best way to perform a breast augmentation is via the IMF, under the breast, where the breast meets the chest wall, The scar is small approx. 2 1/2 inches and heals out quite nicely.

Hello and thank you for your question! An incision line from a breast augmentation is quite minimal. In my practice I typically choose to have the incision line placed directly beneath the breast (inframammary fold). This allows for the incision line to be hidden beneath the breast and is less noticeable.  We also offer the Embrace Scar therapy system to all of our patients. This system helps you achieve the best incision lines. be sure to consult with an American Board Certified Plastic Surgeon to discuss your new look! Good Luck!

All breast augmentation incisions leave scars. And while scarring is a concern, I recommend you base your decision on which procedure produces the best looking overall results and carries the lowest potential for negative outcomes.

Whether you are getting silicone or saline implants, I recommend the inframammary incision in most cases because it allows for extremely precise pocket creation and implant placement.

With inframammary placement, the scar tissue is well hidden underneath the breasts and there is a lower chance of negative outcomes like capsular contracture.

The other two insertion techniques I use are insertion via the axilla (armpit) and insertion via incisions created around the nipples. Both of these are also excellent techniques and have their own benefits and risks.

Armpit incisions leave the breasts completely scar-free. Because the axilla naturally contain a high level of bacteria however, armpit insertion does carry a higher chance of bacterial infection and capsular contracture.

Making periareolar incisions is also an excellent technique. These scars, located around the areola, tend to be extremely small and hard to see. This technique does carry some risks including loss of sensation and potential problems with breastfeeding.

All three of these techniques result in some small level of scarring, but a skilled plastic surgeon can keep this scarring to a minimum. As the scars heal they typically fade to match the color of the surrounding skin -- to the point where they are often nearly invisible. But you should recognize that that is not always the case and the scars may be noticeable in the end.

Always remember to consult with a board-certified plastic surgeon for best practices and best results.

Dr. Kimberly Henry has 4 Breast augmentation before & afters:

Breast augmentation before image performed by Dr. Kimberly HenryBreast augmentation after image performed by Dr. Kimberly HenryBreast augmentation before image performed by Dr. Kimberly HenryBreast augmentation after image performed by Dr. Kimberly HenryBreast augmentation before image performed by Dr. Kimberly HenryBreast augmentation after image performed by Dr. Kimberly HenryBreast augmentation before image performed by Dr. Kimberly HenryBreast augmentation after image performed by Dr. Kimberly Henry

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Scars are an inevitable part of breast augmentation surgery and all other plastic surgery procedures as well. No matter how carefully incisions are made and sutured, there will always be a scar at the incision site.

The good news is that breast augmentation scars can be strategically located as to be out of sight -- and with good surgical techniques and the right postoperative care, the final appearance of the scars can be minimized.

You are correct that there are several incision options for breast implant surgery, each of which has distinct benefits and drawbacks.

The four primary incision sites used for implant placement are: under the inframammary fold beneath the breasts, via the armpit in what is called "transaxillary insertion," via the nipples using a circumareolar incision, and via the belly button.

Insertion through the navel is very rarely used today, and in my opinion is a poor choice as it creates technical difficulties which can lead to negative outcomes.

Every plastic surgeon has their own preferences, although many (if not most) would agree that the inframammary incision allows for the greatest amount of control during pocket creation. In my opinion, inframammary insertion is the best choice in most cases.

Even though inframammary incisions are extremely well hidden under the breast, many breast augmentation patients still prefer the transaxillary method. Breast implantation via the axilla leaves breast implant scars in the armpits. While there is somewhat less control with this method during pocket creation and implant placement, we have achieved excellent results with transaxillary insertion as well.

Patients should understand that there is a slightly higher chance of bacterial infection and capsular contracture with this method.

Keep in mind that while implant insertion via the armpit may leave your breasts scar-free, the scar location in the armpit may still be visible when wearing sleeveless dresses. Transaxillary insertion is used primarily with saline implants, although, depending on implant size, it is possible to insert silicone implants via this method as well.

I suggest you discuss your concerns and your specific goals with a board-certified plastic surgeon, who has experience with multiple surgical techniques and can show you before and after photos of previous successes.

Dr. Frederic Corbin has 1 Breast augmentation before & after:

Breast augmentation before image performed by Dr. Frederic CorbinBreast augmentation after image performed by Dr. Frederic Corbin

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Yes, there are certain approaches to breast augmentation surgery that result in less obvious scarring.

However, it's important to note that all plastic surgery procedures create scars. The goal is to conceal those scars and make them as inconspicuous as possible.

It’s also important to note that the choice of which surgical approach to use depends on many factors besides the potential for scarring.

There is the question of which type of implants will be used (saline, silicone or silicone gel), the implant size and your existing breast anatomy.

Depending on your existing breast anatomy, we would likely recommend either a transaxillary (via the armpit) or an inframammary (underneath the breast fold) approach to breast surgery to minimize visible scars.

The transaxillary approach is by far the least visible. It creates small scars in and around the armpit which are naturally concealed and fade over time. While this approach leaves the least visible scars, it does have some issues -- like making it more difficult to access and remove scar tissue in the (unlikely) event of capsular contracture.

 

The most popular approach in the US is the inframammary approach, which creates small scars in the natural skin fold underneath the breast. This is  good because it gives your plastic surgeon an excellent amount of control over implant placement and pocket creation. While the scarring is slightly more visible here than with the transaxillary approach, the implant positioning is precise.

For anyone concerned, neither the transaxillary nor the inframammary approach has any effect on breastfeeding.

If visible scars are your primary concern, one approach we likely wouldn’t recommend is the periareolar approach, which requires incisions around the areolar tissue. This area is the focal point of the breast and has total visibility.

I encourage you to schedule a consultation with a board-certified plastic surgeon to discuss which approach will deliver the best results for you personally, in all aspects.

Dr. Robert Brueck has 1 Breast augmentation before & after:

Breast augmentation before image performed by Dr. Robert BrueckBreast augmentation after image performed by Dr. Robert Brueck

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Dear CTGirl: 

Cosmetic incisions are placed in the least visible areas of the surgical site. For a breast augmentation, depending on the technique and skills of the surgeon, the incisions maybe placed:

  1. at the new inferior breast crease (IMC - inframammary crease)
  2. just inside the areola
  3. under the arm

The placement of a saline implant (placed flat and filled in the breast pocket) typically needs a 1 inch / 2 cm incision along the areola or IMC and 4 to 6 cm under the arm

A gel implant (placed full filled)  may need a 2 inch / 4 to 5 cm areola or IMC incision and the same 6 cm incision under the arm.

Generally, the scars heal with a near imperceptible line but this cannot be guaranteed. Please speak with your Board Certified Plastic Surgeon regarding:

  • incision site
  • pocket layer placement for the implant
  • expectations for your scar.

Wishing you the best!

Dean Kane, MD, FACS

https://drdeankane.com/?s=breast+augmentation+scar 

scars from her breast augmentation are generally very well accepted.  While I performed breast augmentation through an incision around the nipple for 20 years or recently changed to an incision below the breast because recent studies of shown this approach to have the least amount of capsular contractions (hardening of the breast).  For several years or did the transaxillary oral armpit incisions but found that perfect positioning through this approach was a little bit more challenging.  Saline implants can opt and be placed through smaller incisions because the implant is placed partially filled or empty and intact filled inside.  With the use of a device called a Keller funnel large silicone implants can be place through smaller incisions.  I would discuss these concerns with her surgeon and they can show U great scars, mediocre scars, and bad scars and let you get involved in the decision-making.

Dr. Manuel Pena has 3 Breast augmentation before & afters:

Breast augmentation before image performed by Dr. Manuel PenaBreast augmentation after image performed by Dr. Manuel PenaBreast augmentation before image performed by Dr. Manuel PenaBreast augmentation after image performed by Dr. Manuel PenaBreast augmentation before image performed by Dr. Manuel PenaBreast augmentation after image performed by Dr. Manuel Pena

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Breast augmentation scars are very rarely a problem.  In my practice the scar is under the breast fold, and by the time the patient is seen in my office at 6 weeks, the scar is imperceptible.  That being said we have no control over how your body will heal and occasionally, although, rarely a patient will develop poor scarring.  

Dr. Arthur Shektman has 4 Breast augmentation, Breast lift before & afters:

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Breast augmentation scars are usually very very acceptable. Occasionally you will have a patient who scars poorly either due to their own genetics Or due to trouble healing. However most scars are hard to find on patients after a year or so. There are a variety of incisions including going through the armpit, underneath the breast, around the nipple, and other incisions searches through the bellybutton which most plastic surgeons do not do and it voids the warranty on the implants. larger implants, silicone implants, especially the more cohesive implants such as the gummy bear implants require a larger incision. With a larger incision, the underneath the breast IMF incision is the best in my opinion.

Dr. Christopher Park has 7 Breast Augmentation before & afters:

Breast Augmentation before image performed by Dr. Christopher ParkBreast Augmentation after image performed by Dr. Christopher ParkBreast Augmentation before image performed by Dr. Christopher ParkBreast Augmentation after image performed by Dr. Christopher ParkBreast Augmentation before image performed by Dr. Christopher ParkBreast Augmentation after image performed by Dr. Christopher ParkBreast Augmentation before image performed by Dr. Christopher ParkBreast Augmentation after image performed by Dr. Christopher Park

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The scar for a straightforward breast augmentation is usually small and inconspicuous. Have a consultation with a plastic surgeon and they can show you examples. Good Luck!

Dr. Barry Handler has 1 Breast augmentation before & after:

Breast augmentation before image performed by Dr. Barry HandlerBreast augmentation after image performed by Dr. Barry Handler

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In general, breast augmentations heal with nice, fairly faint scars. The techniques least likely to be visible are the periareolar (around the nipple), transaxillary (armpit) and transumbilical (belly button, not done by most plastic surgeons for a variety of reasons), although the inframammary (breast fold) is still extremely popular and often very hard to see from a scar standpoint. The size of the scar depends mostly on the size of the implant, with silicone implants requiring larger incisions because they are fully filled before insertion whereas saline are inflated after placement. Inframammary has become more popular again because it appears to have a lower rate of exposure of the implant to "biofilm" which is a mix of skin bacteria and proteins that can get onto an implant during surgery and may be the main contributor to capsular contracture. So many plastic surgeons are doing more inframammary approaches again in order to reduce the risk of capsular contracture and since the scars are generally excellent, the tradeoff appears minimal although if you are really obsessive about the scar visibility, you may prefer a periareolar or transaxillary approach. If you need a lift, the scar considerations change considerably since there is at least a periareolar and often a vertical and/or horizontal incision involved in all lifts. Find more info here: http://www.timsayedmd.com/breast-plastic-surgery-newport-beach/breast-augmentation/ -- Dr. Sayed For more info, Visit Us at http://www.timsayedmd.com Email Us at info@timsayedmd.com Call Us at 1-858-24SAYED (1-858-247-2933) Follow us on Twitter and Instagram: @timsayedmd

Dr. Tim Sayed has 9 Breast Augmentation before & afters:

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