Breast augmentation surgery can generally be performed through three incision sites: the axillary incision, the periareolar incision, and the inframammary fold incision. Choosing the most suitable incision site is often a concern for patients seeking cosmetic enhancement.
The axillary incision is hidden within the crease of the armpit hair region and remains highly concealed when standing upright. This is why many patients request this approach. However, this concealment is relative; wearing sleeveless clothing in summer may expose the surgical scar.
2. Implant displacement and asymmetry frequently occur with axillary incision breast augmentation.
Additionally, from a purely technical perspective of breast augmentation surgery, axillary incisions present two primary challenges. The first is achieving precise dissection.Among all incision sites, the axillary approach is the farthest from the inframammary fold, making dissection of this area the least controllable. As a result, axillary incision breast augmentation frequently leads to implant displacement and asymmetry.While endoscopic technology can partially address this issue, it significantly extends surgical duration. The high cost of endoscopic equipment and the demanding technical requirements also limit its widespread adoption.
3. Axillary incisions cannot accommodate all surgical needs
The second limitation of axillary incisions is their inability to handle complex breast procedures.To put it plainly, if a patient has glandular ptosis requiring simultaneous correction, axillary incisions cannot be used for breast augmentation. Additionally, severe capsular contracture, implant repositioning, and double-lumen deformity correction all necessitate additional incisions around the areola or inframammary fold.
II. Areolar Incision
This incision offers the most direct access, functioning as a nearly universal approach. It ensures all surgical maneuvers are performed under direct visualization, providing exceptional control and predictable outcomes—making it the author's preferred technique. However, for Asian patients, particularly young, nulliparous women, the areola is often too small for this approach to be suitable.
III. Inframammary Fold Incision
This incision offers multiple advantages and has long been favored by Western scholars.
Many patients opt for inframammary fold breast augmentation after embracing the dual-plane augmentation concept. The inframammary approach shares similarities with the areolar incision, both enabling direct visualization and precise control over intricate details.Early on, Eastern scholars rejected this approach, believing it prone to hypertrophic scarring. However, with the maturation and widespread adoption of scar management techniques, this incision now leaves minimal visible traces. It is gradually gaining popularity domestically and represents a viable breast augmentation approach.
Each incision type has distinct advantages and limitations. The axillary approach offers the compelling benefit of no visible scar on the front, but it cannot accommodate complex glandular manipulations and is not universally suitable. Both the areolar and inframammary approaches allow direct visualization throughout the procedure, enabling correction of various primary or secondary breast contour issues. Their broader applicability explains why major centers frequently favor these techniques.