There are four incisions that can be used to insert a breast implant for breast augmentation and each has its pros and cons. One of the more popular incisions is located in the breast crease, under the breast, which is called an inframammary incision. This incision is about 4-5cm in length and can be used for both saline and silicone breast implants. This incision allows easy access to place the implants under the pectoral muscle without violating the breast tissue/milk ducts and therefore allows a very high percentage of patients to still breast feed after surgery. This incision also has perhaps the lowest rate of capsular contracture rate (which is hard scar tissue that forms around breast implants). Another common approach to breast implant insertion is the periareolar incision, near the nipple. This incision however does disrupt some of the milk ducts and can interfere with breast feeding. It is also associated with a higher capsular contracture rate as the bacteria in the milk ducts can come into contact with the implant and cause inflammation which may lead to hard scar tissue. A less common incision for breast augmentation is the transaxillary (armpit) incision. This incision is heals fairly well in the armpit skin however the implants have a tendency to look a bit off to the side, since they are inserted from a more lateral (side) approach. Creating the breast implant pocket is more difficult and less precise than the previously mentioned incisions. It is also very difficult to create any look of cleavage via the armpit incision.  The final and least popular approach is the transumbilical (bellybutton) incison. Only saline implants can be placed through the bellybutton (not silicone). If the implants rupture or need revision, you can not exchange the implants through the bellybutton approach. The final decision as to which incision is best for a breast augmentation depends upon each patient’s anatomy and their specific desires. This should be addressed in detail during the consultation visit.