If you are considering breast augmentation, you probably have questions about the scars. Scars are a common concern for anyone undergoing cosmetic surgery. In our clinic, questions about scars have four themes:

1. Length
2. Location
3. Healing time
4. Visibility

This article breaks down these four concerns while giving you a comprehensive guide to breast augmentation scars. This type of information is important for you to understand before you move forward with surgery and it will allow you to make a more educated decision on the surgical approach.

Length of the scarThe length of the scar will depend on the type of implant, saline or silicone, used for your surgery. Placing saline implants requires a shorter scar, while placing silicone implants requires slightly longer scars. Here is the breakdown:

• Saline implants: These implants are filled during surgery, after being placed under your breasts. Therefore the incision for insertion is relatively short, between 1 to 1.5 inches.
• Silicone implants: As they come pre filled, the incision required will be slightly longer for insertion. The length is between 1.5 to 2 inches.

Location of the scar There are three options for placement of your breast augmentation scar – within your armpit, around your areola, and at the base of your breast. Each has its benefits. Our preferred approach depends on your exam and overall goals. But, equally important, is having your input. You should have a say in deciding on the scar location. It is a personal choice. So let’s explore the pros and cons of the 3 different approaches:

In your armpit* It has the clear benefit of not putting the scar on the breast itself. * In this location, the scar is visible with certain types of clothing. Think sleeveless tops or dresses. In other words, it is harder to cover. * It also puts the incision father away from the important structures that are addressed during surgery.

Around your areola * It has the benefit of having better access to important structures than the armpit incision and it is easily combined with a breast lift procedure. * Although the scar fades well over time, it may remain slightly visible, so you’ll see it when looking in the mirror. * There’s a higher risk of contaminating the implant with this type of incision since you’re operating closer to the milk ducts of the breasts.

Base of your breasts* This is the gold standard approach. It gives us the most surgical options, with the best visibility and access to important structures. * This scar will also fade well over time but may remain slightly visible. It won’t be visible when looking in the mirror while standing. * Due to its location, this scar can sometimes be irritated by bras, especially ones with more under support.

The healing time and visibility If you go to an experienced plastic surgeon, breast augmentation scars should not be a concern. They will appear thin and symmetrical. Most importantly, they fade drastically in the first 12 months, after which they should only be visible in direct light. It is a reasonable trade from our standpoint. Having a dramatic improvement in the appearance of your breast outweighs the drawbacks of having a minimally perceptible, 2 inch scar, hidden around your breast or armpit.

The bottom line on breast augmentation scarsHere are the factors that help us decide which approach would be the best fit for you:

• Your implant type: If you chose a saline implant, this may lend well to an armpit or areola approach. If you choose a silicone implant, especially larger ones, the base of the breast incision works best.
• Your anatomy: Your unique anatomy will also guide us with incision choice. For example, if your areola is smaller, the around-the-areola approach may not work well with silicone implants. it would be hard to fit.
• Your preference: This has the biggest bearing on our approach and where the ultimate scar is located

There is no doubt that the base of the breast incision in breast augmentation offers us the most flexibility. But the other approaches have their benefits too. If you specifically

want moderate to large volume silicone implants (greater than 500cc for example), the armpit and around the areola approaches have a few limitations:

• The incisions required will be larger and thus more visible due to the location
• The dissection can be more difficult with these approaches making the placement harder
• Releasing the muscle adequately is slightly more challenging, increasing the risk of your implant riding high

Understanding your preference for the scar location is critical to helping us figure out our surgical approach. As we offer all three options, we will let you know if these factors line up with your preference. And if it doesn’t, we will suggest an alternative. It is that simple. But no matter the approach, you should expect that these scars heal quickly and will be nearly imperceptible by 12 months. Therefore, don’t put too much emphasis on their appearance. Most importantly, please reach out with any questions regarding breast augmentation scars. We are here to help you make the most informed decision.