There are four ways in which to insert a breast implant:
3.Inframammary (breast crease)
4.Transumbilical (belly button)
The incision through the axilla hides the scar in the armpit crease. This approach can be difficult to insert larger silicone breast implants. If you should need a revision in the future, this approach can have limited access and you may need a second incision in order to effectively remove or replace the implant.
The areolar approach to breast augmentation is quite popular as the final scar is hidden along the border of the lower portion of the areola. Some patients with very small areolas may not be eligible for silicone implants inserted through this approach. This approach also involves cutting through some of the breast tissue and milk ducts which can lead to bacterial contamination of the new implants which can cause hard scar tissue to develop around the implants (capsular contracture).
The inframammary incision is hidden in the breast crease or fold just under the breast. The incision is about 4-4.5 cm long for the placement of silicone implants. This approach is associated with a higher chance of breast feeding and a lower incidence of capsular contracture (hard scar tissue).
The transumbilical or belly button approach for breast augmentation is limited only to saline implants. If the implant leaks or ruptures, it can not easily be replaced through this approach and you will likely require a second scar somewhere else. Should you develop hard scar tissue with this approach, a revision can not be performed through the belly button.
Each incision carries about a 10% risk of decreased nipple sensation.
A board certified plastic surgeon can examine you and determine which approach to breast augmentation is best for your particular case.