Breast implants are placed through three incisions. A. Axillary, or underarm, approach. B. Areolar approach. C. Inframammary, or breast fold, approach.
So, which breast augmentation approach is best for you?
This decision is deeply personal and hinges on the aesthetic goals you want to achieve. Some women opt for the classic inframammary fold (IMF) approach, where the small scar is hidden by the natural crease and easily concealed with clothing—even under a bikini top. However, many women embrace the scarless axillary technique to eliminate any visible scar on the breast, whether in the mirror or during intimate moments. It’s important to note that while the IMF approach is common, especially because many surgeons stick to it due to its straightforward nature, the scarless axillary method is equally effective—and in fact, it’s the preferred choice in certain parts of the world, especially in Japan and China. Unfortunately, many American women have never seen this approach, not because it does not deliver beautiful results, but simply because fewer American surgeons are skilled in this technically demanding technique. Dr. Connall, on the other hand, is uniquely experienced in the axillary endoscopic method, offering you a truly innovative, scarless option.
Both approaches can yield stunning, natural-looking results with minimal risk. Additionally, when implants are placed above the muscle or subfascial, recovery becomes even easier with reduced discomfort and quicker return to daily activities. Dr. Connall ensures every method is performed gently, with a rapid recovery process that lets you enjoy your transformation sooner.
At Esprit® Cosmetic Surgeons, we encourage you to keep an open mind as you decide how you want to look and feel with your breast augmentation. Our expert plastic surgeon in Portland OR will guide you through your options until you find the approach that aligns perfectly with your vision.
To help you with this process, we have created the following table with several important advantages and disadvantages of each breast augmentation approach for you to consider.
Classic Intramammary, Breast Crease
Advantages
- Provides direct visualization for precise pocket creation and implant positioning.
- In patients with deep folds, the scar discreetly hides in the natural crease.
- Ideal for complex surgeries and internal mesh bra placement.
- Excellent for correcting sagging or tuberous breasts, restoring a youthful shape.
Disadvantages
- Leaves a scar on the breast.
- More noticeable on small, firm breasts lacking deep folds.
- Scar visibility may increase during intimate moments.
Scarless Axillary Endoscopic
Advantages
- No scar appears on the breast.
- The small underarm incision blends into the natural crease and is nearly invisible.
- Offers the least visible scar among all breast augmentation approaches.
- Dr. Connall’s expert, precise technique delivers beautiful, consistent results.
Disadvantages
- On rare occasions, a slight scar may be visible in sleeveless tops.
- May be less effective for cases of mild sagging or tuberous breasts.
- Can make additional surgery more challenging if revisions are needed.
Areolar*
* Not routinely performed by Dr. Connall.
Advantages
- Allows direct visualization for precise pocket creation and implant placement.
- In some cases, the scar can be well hidden within the areolar border.
- Can be effective for managing mild sagging or tuberous breasts.
Disadvantages
- Involves operating on an extremely sensitive area that most patients prefer to avoid.
- Scar is often prominent and becomes a focal point on the breast.
- Exposes the implant to bacteria from the breast tissue, increasing infection risks.
- Heightens the likelihood of capsular contracture.
- May result in reduced sensation around the areola.
- Carries the greatest risk of complications with future breastfeeding.
Choosing the right breast augmentation incision for your body type is important to achieving satisfactory results. For more information on incision types, contact Esprit® Cosmetic Surgeons in Portland at (503) 783-0544 or online.
