Breast Augmentation Incisions Augmentation Incisions

Periareolar: The incision which goes around the edge of the dark areola that surrounds the nipple (usually the lower half)  is used to insert the implant.


  • The scar usually blends wells well with the surrounding tissue.
  • The same incision can be used again if later surgeries are needed.
  • The space for the implant can be seen clearly with direct vision.


  • The incidence of infection after surgery may be minimally greater.
  • Breastfeeding in the future may be interfered with in some but not in most patients.
  • Nipple sensation may be decreased, but it is usually temporary.
  • While the scar usually blends in at the edge of the areola, there is also a chance it could be lighter or darker than the adjacent tissue.
  • If the areola is too small, the incision may not be a good option for larger silicone gel implants.
  • Potential slightly higher risk of capsular contraction.

Inframammary: The incision is placed at the bottom of the breast near the crease called the inframammary fold. This is the most  commonly-used incision today.


  • The same incision can be used again if later surgeries are needed.
  • The space for the implant can be seen clearly with direct vision.
  • Slightly lower risk of infection.
  • While it is a visible scar, the position underneath the breast in the fold means it is usually not visible while standing without clothes.
  • Potential slightly lower risk of capsular contraction.


  • The scar can be visible on the breast when lying down.
  • Placement higher or lower on the breast will make the incision visible.
  • If there is a secondary procedure to place a larger implant, the scar may be located higher on the breast. If a smaller implant is placed, the crease may be raised, exposing the scar in a lower position, possibly in view under a bra or swimsuit.
  • Longer appearing incision than around the areola.
  • May not blend in as well as a periareolar scar.

Transaxillary: The incision is made in the crease of the armpit. Some surgeons use an endoscope ( internal camera) to assist in creating the space for the implant while others use a blind  approach.


  • There is no scar on the breast itself.


  • If a camera is not used there is no visualization of the surgical pocket which may result in less control.
  • A higher risk of asymmetry.
  • An increased chance of bleeding requiring re-operation.
  • If there are complications during the procedure, a separate incision may have to be made on the breast.
  • The armpit scar can be a problem when larger silicone implants may not work well with this choice.
  • The armpit scar will be visible when wearing sleeveless shirts.
  • A potential be permanent numbness of the surrounding tissue under the arm and onto the shoulder.
  • The same incision cannot be used again if later surgeries are needed, which would require a separate incision on the breast.

Transumbilical: The implants are inserted through the incision in the belly button. Some surgeons use a camera to assist and some do not. There are many drawbacks and most surgeons do not recommend this approach.


  • The scar is usually hidden in the belly button.


  • There is no visualization of the surgical area. It is a blind procedure.
  • Increased risk of complications to the surrounding tissue and bleeding.
  • Saline implants are the only option for this incision choice.
  • The scar could be visible and quite noticeable.
  • Placing the implants correctly can be difficult causing a greater risk of asymmetry.
  • If there are complications during the procedure, a separate incision on the breast may be necessary.
  • The same incision cannot be used again if later surgeries are needed, requiring a separate incision on the breast.
  • This option is much more difficult to perform reliably.

Why Choose Dr. Singer?

Dr. Singer has the respect of his peers and patients across San Diego and the surrounding Southern California area. He has helped thousands of San Diego residents with an eye for balance and beauty and the skills of an artist. Dr. Singer has been engaged in private practice in the La Jolla area of San Diego since 1976 and is now an internationally recognized plastic surgeon. You are in the best of hands with Board Certified Plastic Surgeon (American Board of Plastic Surgery) Dr. Singer.

Please learn more about Dr. Singer’s affiliations, memberships, awards, honors, and accomplishments. The full list and Dr. Singer’s curriculum vitae are available upon request.

Dr. Robert Singer

Robert Singer, M.D.

Dr. Robert Singer is a board-certified plastic surgeon and former President and Chair of the Board of Trustees of The Aesthetic Society who gives his patients life-changing results. His technical mastery and artistic sensibilities have helped thousands of patients achieve natural-looking rejuvenation through facelifts and other complex procedures. Dr. Singer is a member of several prestigious organizations, including:

  • Aesthetic Surgery Education and Research Foundation, Founder and Prior President
  • QUAD A, Prior President
  • San Diego Plastic Surgery Society, Prior President
  • California Society of Plastic Surgeons, Prior President
  • Chosen by his peers as the inaugural visiting professor of California Society of Plastic Surgeons (CSPS) for all academic plastic surgery programs in California: UC Davis, UC San Diego, UC San Francisco, Loma Linda University, Stanford University, UC Irvine and USC
  • American Society of Plastic Surgeons, Prior Chairman of the Board of Trustees
  • International Society of Aesthetic Plastic Surgeons, Member of numerous task forces including Patient Safety
  • American College of Surgeons 

To discover what Dr. Singer can do for you, request your consultation online or call his plastic surgery practice at (858) 455-0290.

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