If you were to poll ten plastic surgeons, you would get ten different answers. Each plastic surgeon has their own philosophy. My best advice is to make your decision after talking to your plastic surgeon decide. This is a big decision and you must consider not only the positives, but also the negatives.

The only advantage to the transaxillary incision is that you don’t have a scar on the breast. There are, however, many negative to this approach: (1) a scar in the axilla can be seen when raising the arms, (2) if the scar becomes hypertrophic it may interfere with shaving, (3) the implants have a tendency to ride high because of the dissection during implant placement, (4) it is hard to place large silicone implants through this approach, (5) surgery time (and hence, your cost) tends to be longer, and (6) subsequent surgeries tend to require a second incision. In other words, when it’s time to have your implants replaced, it is unlikely that your plastic surgeon with use this approach again – especially if you needs a breast lift or capsulectomy. The result is that now may end up with two incisions.

The periareolar incision is a good approach, especially if you need a small lift at the same time. When it heals well it looks great. But there are a few things to consider. This approach puts the incision right on the breast. Therefore, if the incision doesn’t heal well (scar hyperthrophy, widening, darkening) you will see this every time you looks in the mirror. There is also an increased risk of infection. Nevertheless, if you have dark, moderately sized areolas, this could be a good approach.

Usually, I recommend the inframammary (under the breast) approach because it is quick, straightforward and the scar is well hidden when looking at the breast straight on. It is also easy to perform a revision through this approach. When I combine this approach with a dual plane breast augmentation (for ladies with some sagging after children) this gives a very nice predictable result.

Hope this helps
Dr Jimerson