The other incisions used for breast augmentation are a distance away from the breast mound and because of this, they may compromise some of the access to the capsule and implant pocket. The axillary, arm pit, incision is still popular and has the advantage of being away from the breast mound in terms of scarring on the breast. The axilla has important blood vessels, nerves and lymphatic tissues which can increase potential risks and this incision can be slightly more painful following plastic surgery. Some plastic surgeons will leave drains following an axillary approach as the lymphatic drainage may increase the risk of fluid collections.
The umbilical, belly button, approach is the furthest away from the breast mound and it would be very difficult to do anything else aside from placing an empty saline breast implant which can then be filled in the pocket. It is important for your plastic surgeon to offer their patients a choice and spend time educating them on the pros and cons of each option so they can make an informed decision.
Patients also have a choice as to whether they want their breast implant placed above or below the pectoralis muscle and the advantages and disadvantages to this depend mostly on each patient’s individual anatomy. Placing the breast implant below the muscle allows more of the patients’ own tissue to cover the implant and look more natural. It also can cause more distortion of the breast mound with muscle movement. Most submuscular (below the muscle) procedures are only partially under the muscle as the lower border of the breast mound is below where the muscle would attach to the rib cage and this is released during the surgery. Each patient will need to discuss their anatomy and physical characteristics with their plastic surgeon to decide which placement is best for them.