Is it best to have breast augmentation done under the armit?
I want a natural look without scarring on my breasts. Is it best to have breast implants done under the armpit? Will they look better if the incision was made somewhere else? What other things should I be thinking about?
When making decisions about breast augmentation, one basic underlying fact must be accepted. Breast augmentation is, by its very nature, an unnatural thing to do to your breasts so obtaining an entirely natural result is not realistic. Among the decisions to be made are which incision to use, where to place the implant (above vs under the muscle), saline vs gel implant, implant type (round vs anatomical, smooth vs textured, cohesive gel vs form stable (also known as "gummy bear" implant), and how to choose a size. Of these, the incision is arguably the least important. There are four options for the incision site. The belly button is, I feel, a gimmick that is impractical for most patients. It can be used only with saline implants, limits the surgeon greatly in shaping the implant pocket and positioning the implant, and does not allow for revisions or dealing with complications. Very few surgeons use this. Even those who promote it in their practices, I believe, do so to attract patients and do other incisions preferentially. The armpit was popular 30 years ago. Suffice it to say that the surgeon who was most instrumental in popularizing it no longer uses it. It also has problems with implant malposition and cannot be reused it problems arise. Both of these were developed primarily for women who will be exposing their breasts publicly, e.g. topless dancers and strippers.
I don't like the incision along the edge of the areola. This is the aesthetic focal point of the female breast; it is what draws your eyes to the breast. Why would you put a scar there? Even if perfect, it is more likely to cause loss of sensation in that important area and my affect the ability to breast feed later. The incision under the breast is, by far, the most popular. It makes the operation easier, can be reused repeatedly, and problems with the scar are uncommon. No one will see it unless they see your bare breast and even then, it tends to be very inconspicuous. It is usually 1-3 inches long, depending on the implant chosen. I have yet to hear a complaint about this incision location.
There are 3 main options for scar placement. In the armpit, around the areola, or under the breast. You can achieve a natural look with any of those incision sites. In my practice, the most common incision is under the breast, and I have lots of happy patients! Best bet would be to meet with your PS to figure out which one would be best for you. Best of luck!
Dr. Jonathan Heistein has 17 Breast Augmentation before & afters: