Preferred Implantation Site

Is There a Preferred Breast Implant Insertion Site?

Implants may be inserted from a variety of locations: Saline and silicone implants may be placed above or below the muscle via the periareolar, axillary and inframammary incisions. Only saline implants may be inserted via the umbilical incision.

Generally, the axillary incision is th least cosmetic because it is visible with sleeveless tops. The most cosmetic incision is the navel incision because there are no visible scars around the breast. However, only saline implants can be placed via the navel. The navel approach requires more work and we charge $1,000 more for this approach.

After the navel incision, the periareolar (nipple) and inframammary incisions are more cosmetic than the axillary incision. If the breast implant will be large enough to cause folding over the breast crease, the inframammary incision will be hidden and preferable to the areolar incision. On the other hand, if the breast implants are smaller and do not cause folding at the breast crease, then areolar incision will be less visible.

Case 1: Trans-Umbilical Breast Augmentation (TUBA). In this case, the patient had her above muscle saline implants placed via an umbilical incision. Notice there are no scars around the breast. The TUBA is the most cosmetic incision, but takes more time and costs $1,000 more than other incisions.


Case 2: Inframmamary Incision. Although not as cosmetic as the TUBA, it takes less time to perform and is very cosmetic.

Tuberous (Snoopy-Nose) Breast
(Nipple Incision)

Case 3: Periareolar incision is very cosmetic. This is the most versatile incision. It is preferred for breast and areolar reconstruction, Benelli lift (mastopexy) and correction of breast and areolar abnormalities.

In this case, the periareolar incision was used to correct tuberous (Snoopy-nose) breasts.

Contrary to popular belief, periareolar incisions do NOT result in more numbness to the nipple.

Adjustable Implants

Some patients desire adjustable saline implants. These implants may be adjusted months or even years later. Almost all patients are not symmetrical between their right and left sides because of normal differences between the breasts and/or (pectoralis) muscles. Actually, a small normal asymmetry looks more natural. However for some patients, these size differences may be dramatic. In such cases, adjustable implants may be considered.

Then again, some patients like adjustable implants because they can fine-tune their breast size when they’re awake, after trying a variety of clothes. Adjusting these implants (larger or smaller) can be performed during a 10 minute office visit. Some professional models, dancers, etc. like to adjust their implants before a particular event or shoot.

Finally, there are those patients who try to achieve near-perfect symmetry between their breasts. For those women, adjustable implants is the way to go. However, as is seen below, near perfect breast symmetry may not look as natural as slight breast asymmetry.