People who opt for cosmetic surgery do so because they want to change and improve their appearance in some way.  But a question that inevitably emerges is: "Will a scar from surgery negate my attempts to look better?" The answer varies depending on what area of the body will be undergoing surgery, as well as the experience and skill of the surgeon you choose. For breast-related surgeries, we need to consider the type of procedure as well. Scars from augmentation with implants will look different from scars related to reconstruction, or an augmentation performed with the patient’s own fat. This article focuses on scars from augmentation with implants.

What Affects The Appearance Of A Scar?

To understand possible scars from breast enlargement surgery, you first need to understand your implant options, as well as what incisions are available. Both types of implants (silicone and saline) have pros and cons. In terms of scarring, saline implants can be filled after they have been placed, whereas silicone implants come in standard, prefilled sizes.

This means that a surgeon only needs to make a small incision for a saline implant shell and necessary instruments. But for a silicone implant, the incision must be large enough to accommodate the entire volume of the implant. Choosing an extremely large (vs. smaller) silicone implant will also require you to reevaluate your scar/incision priorities, as incision options become more limited with large implants. Additionally, the size and coloration of your areola may be another factor if you are considering the periareolar incision specifically.

How Do The Different Incision Options Compare In Scarring?

In terms of incisions, all possible incision sites for breast enlargement were designed with the goal of minimizing visible scars. The surgeon may make the incision in: the armpit (transaxillary), in the crease below the breast (inframammary), around the areola (periareolar), or, perhaps surprisingly, near the belly button (transumbilical breast augmentation, aka “TUBA”). 

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  • Transaxillary incisions can be made going sideways or up/down. Depending on the direction you choose, the scar may look like a natural wrinkle in your armpit.
  • Periareolar incisions are made along the edge of the areola, under the nipple. Because the areola is a darker color than the skin surrounding it, the scar is likely to blend in and be less noticeable, causing some surgeons to recommend it as the best option for minimal scarring. If it is done well by a skilled surgeon, it may be extremely difficult to detect at all.  It is possible for this scar to spread, but much less likely than with the inframammary type.
  • Inframammary incisions are made in the crease under the breast. As breast size increases, so does the likelihood of the breast itself covering any scarring that may occur. Although this incision is a better option than the periareolar incision for very large silicone implants, it may be visible in a bikini top. This scar can enlarge and require later revision.
  • TUBA procedures are not performed by all surgeons because the approach (through the belly button area) is so unique. However, one of the major advantages of TUBA is to remove all scars from the breast. The scars near the belly button usually heal well and are almost imperceptible.  

If you are worried about your partner or someone else seeing scarring on your breasts, or you fear you will feel more self-conscious naked or while having sex, the transaxillary and TUBA incisions completely eliminate the possibility of having any scarring on the breast. Keep in mind, however, that periareolar incisions can also heal quite well. When making your decision, ask to see pictures of scars that have resulted from actual enlargements the surgeon has performed.