Breast augmentation incisions illustration esprit® cosmetic surgeons

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 is a very personal decision, and mostly depends on the aesthetics you are trying to achieve. Some women prefer the breast crease scars because those are always hidden with clothing, even with a small bikini top. Others choose the axillary approach to avoid scars on the breast that may be visible while looking at the breasts in a mirror or during intimate encounters.

For the most part, beautiful results can be achieved with both incisions and with low risks. So, Esprit Cosmetic Surgeons recommend that you make this decision mostly based on how you want to look and feel with your breast augmentation. Our plastic surgeon in Portland, OR will guide you through your options until you find the approach for you.

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:


Breast Crease


  • Direct visibility of pocket creation and implant positioning.
  • In patients with deep folds, the scar is hidden by the breast.
  • Excellent approach for additional breast surgery.
  • Excellent approach for treatment of cases of mildly sagging or tuberous breasts.
  • Preferred access for placement of shaped, “gummy bear” cohesive silicone gel implants.


  • Scar on the breast.
  • Hard to hide scar on small, tight breasts, without deep folds.
  • Scar may be visible when you are lying flat.

Axillary Endoscopic


  • No scar on the breast.
  • Scar often blends into skin crease well and is hard to detect.
  • Usually least visible of augmentation scars.
  • Endoscopic technique provides full visibility and precise surgical control of pocket creation and implant placement.


  • A poor scar (which is not typical) may be visible in sleeveless tops
  • Limited in treatment of some cases of mildly sagging or tuberous breasts.
  • Additional surgery may be difficult with this approach.
  • Very small risk of numbness of the skin around the underarm and upper arm.

We Are Here To Help

The best way to get your questions answered is to come in for an appointment.


* Not routinely performed by Dr. Connall.


  • Direct visibility of pocket creation and implant positioning.
  • Scar may be well hidden by areolar tissue.
  • Good approach for additional breast surgery.
  • Good approach for treatment of cases of mildly sagging or tuberous breast.


  • Most women do not want this sensitive area operated on.
  • Scar is often visible and is at the focal point of the breast.
  • Exposes the implant to breast tissue and bacteria within the breast tissue.
  • Implant exposure to bacteria increases the risk of capsular contracture.
  • Some sensory nerves around the areola are cut.
  • Greatest risk of problems 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 our office in Portland at (503) 783-0544 or online.