How Do You Know Which Incision Location Will be Best for You?

There is much debate and discussion about incision location preferences, but just like a lot of other issues in breast augmentation – most decisions are based on an opinion instead of truly understanding the pros and cons of each option. Here is some insight about incision locations and tradeoffs from The Best Breast 2. Each day this week we will go into more detail on each incision location: Inframammary, Periareolar, Axillary and Transumbilical.

Based on twenty years of experience with all incision locations, I am convinced of the following:

Most patients worry far more about incision location before the surgery than they care after the surgery (provided they have a good result).

If an incision is on you, you will notice it!

If you have a beautiful breast, neither you nor anyone else will care where the incision is located.

Every patient thinks that the incision location she has is best.

Incision location is a common way that surgeons use to market their augmentation practice. If a surgeon touts the ‘X incision’" as unquestionably the best, and states,

"I am the expert at the "X incision," run the other way.

No incision is best, and the likely message is that the surgeon doesn’t know how to do it any other way.

If a surgeon is experienced with all incision locations, the surgeon will offer you all options.

If you hear negative comments about an incision location from another patient or surgeon, it’s usually because neither has much experience with that incision location.

No incision location is always best. Each location has advantages and trade-offs.

Every woman’s breasts, at some time in her life, are likely to acquire a blemish, a stretch mark or a biopsy scar. A well-executed incision scar is usually no more noticeable than these other blemishes, and if the breast is beautiful, who notices? Who cares?

Just because your friend had a certain incision doesn’t mean that incision location is best for you. In most cases, it doesn’t matter. A few, very rare breast deformities are best addressed through a certain incision, and when these deformities occur, we don’t hesitate to tell a patient, "With this specific breast deformity, a specific incision location gives us better control over your operation, and, hopefully, we’ll get a better result." But in over 90 percent of patients that we see, we offer the patient a choice of incision locations. If a surgeon is experienced in all incisional approaches, the surgeon is less likely to recommend one location over another. Instead, the surgeon will give you a full range of options.

What’s really most important about incision location?

How much control it gives your surgeon over your operation.

How much it allows your surgeon to minimize trauma to your tissues.

How far the incision location is from the implant pocket.

How much normal tissue your surgeon must go through before getting to the implant pocket. The greater amount of normal tissue your surgeon has to go through, the more trauma, bleeding, pain, length of your recovery, and possible other complications you should expect.

How many critical structures (mostly nerves and blood vessels) are located near the incision or on a path from the incision to the pocket.

Don’t form an opinion about incision location until you know about all the alternatives! Incision location is one of the LEAST important decisions you’ll make in a breast augmentation. Each incision location has relative advantages and trade-offs.