You can’t have breast augmentation surgery without a scar. There is no such thing as “scarless” surgery. There are “good” scars, hard to see scars. So how do you get one of those good scars? Scarring varies from person to person. Some people are prone to elevated, pigmented, or keloid scars. Scar creams and silicon gel sheeting can help.
As for visibility of the scar, there are three common incisions:
- IMF – inframammary fold—where your underwire goes
- Periareolar—at the junction of the colored portion of the skin and breast skin from 4-8 o’clock
- Axilla—in your armpit
For hiding the scar, I used to like the periareolar approach the best, as I feel it blends and camouflages the best, particularly with people with color in their skin. If your scar turns a little darker, it blends with the areola. If it stays skin-colored, it blends with the breast skin. It is also in a place which is hidden, even in the teeniest of teeny bikinis. It can interfere with future ability to breastfeed, and a recent study links it to a higher rate of capsular contracture.
The IMF scar goes into the crease below the breast or just above it. I try to parallel the natural skin folds to help it hide. If you are standing or wearing a bra, it is likely covered. This is the scar with the lowest risk of biofilm and capsular contracture..
The axilla goes in the armpit. It can be visible when you wear tank tops or similarly open clothing and lift your arm. It is hard to revise implant issues through this incision. And a prominent breast surgeon analyzed his own practice and found it had the highest rate of infection.
If you are a revision breast surgery, I tend to go through your old scar (unless axilla). Benefit is it keeps you to one scar on the breast, but it can have issues.
Scar length?
- Varies with type of implant. The length of your scar is slightly longer with gel implants than with saline.
Things which do not affect your scar:
- Size of implant
- Above or below the muscle
This is a good thing to discuss with your surgeon. The most common scar site is the IMF scar. Studies have linked it to lower rates of capsular contracture. Ideally you want your scar to be as “scarless” as possible. You need to follow good scar care. Keep your appointments. If anything happens (infection, irritation, etc), it can make your scar worse. Please see my blogs on scars.
Editor’s note: The original version of this post was published on April 5, 2012.