Breast Augmentation Incisions: Inframammary, Periareolar, Transaxillary
Key takeaways
- There are three main breast augmentation incisions: inframammary (in the crease under the breast), periareolar (around the nipple), and transaxillary (in the armpit).
- The inframammary incision is the most commonly used and gives the surgeon the most direct access to the implant pocket.
- Any incision near the nipple or that disturbs breast tissue carries some risk to nipple sensation and, potentially, to breastfeeding.
- Whatever the entry point, every breast augmentation leaves a permanent scar that matures over up to a year.
Breast augmentation uses one of three main incisions: inframammary (in the crease under the breast), periareolar (around the nipple), or transaxillary (in the armpit), each putting the scar in a different place and carrying slightly different trade-offs. The implant goes in through that small cut, so where it sits is one of the real choices you make, not a detail to leave entirely to chance. This is the plain version I wish someone had walked me through before my own surgery.
When I was deciding, I was so focused on size and implant type that the incision almost slipped past me. It turned out to be one of the questions my surgeon cared about most, because it shapes where the scar lands and how close the work comes to the nerves and ducts behind the nipple.
The inframammary incision
The inframammary incision sits in the crease under the breast and is the most commonly used approach. It runs along the natural fold, so the scar is hidden in clothing and usually unseen when you stand, though you can see it lying down. The NHS lists it among the standard ways breast implants are placed.
Surgeons reach for it most often because it gives the most direct, controlled access to the implant pocket and works for silicone or saline implants across a wide range of sizes. It also keeps the cut away from the nipple and milk ducts. The trade-off is a scar on the breast itself, low in the fold. Mine is here, and a year on it is a pale, flat line I genuinely forget about most days.
The periareolar incision
The periareolar incision is made around the lower edge of the areola, the darker skin around the nipple. The scar can blend into the natural colour change at that border, which is why some people choose it for how well it hides on the breast.
The trade-off is its position. This approach passes closest to the nerves and ducts beneath the nipple, so it is sometimes linked to a slightly higher chance of altered nipple sensation or an effect on breastfeeding, both of which are recognised risks of augmentation in general. The American Society of Plastic Surgeons notes changes in nipple and breast sensation among the procedure’s possible complications. If breastfeeding or sensation is a priority for you, this is worth weighing carefully and is covered more fully in breast augmentation and breastfeeding.
The transaxillary incision
The transaxillary incision is placed in a fold of the armpit, leaving the breast itself unmarked. For people who do not want any scar on the breast, that is the draw: the entry point is off the breast entirely.
It has trade-offs too. The surgeon works further from the implant pocket, often with a camera to guide placement, and revising or replacing an implant later may still need a separate incision on the breast. It is less suited to some larger implants. Sensation and breastfeeding risks still apply, as they do with every approach, because augmentation alters the breast whatever the route in.
How the incision affects sensation and breastfeeding
Changes to nipple or breast sensation are a recognised risk of breast augmentation through any incision, and they can be permanent. Numbness or heightened sensitivity is common in the first weeks and usually settles, but some change can last. The periareolar route runs nearest the relevant nerves, so it is the one most often discussed in this context.
Breastfeeding can also be affected by augmentation of any kind, though many people breastfeed successfully afterwards. The periareolar incision passes closest to the ducts, so in theory it carries marginally more risk than the others. The FDA’s patient information on breast implants is clear that implants can affect the ability to breastfeed. None of this should be buried in the small print: raise it directly with your surgeon.
The scar is permanent, whichever you choose
Every breast augmentation leaves a permanent scar, and the incision only decides where it sits, not whether there is one. Scars mature over up to a year, fading from raised and pink to a paler, flatter line, and how yours heals depends as much on your skin and aftercare as on the location. The detail on healing and care lives in breast augmentation scars.
The incision is one piece of a bigger decision that also covers implant type, placement, and size. For the full picture, start with the breast augmentation overview, and bring your questions about scar position to a consultation rather than settling them online.
This guide is general information and one patient’s experience, reviewed by a consultant plastic surgeon. It is not a substitute for a consultation with a qualified plastic surgeon who can assess you and advise on the right incision for your case.
References
- Breast Augmentation, American Society of Plastic Surgeons.
- Breast Implants, U.S. Food and Drug Administration.
- Breast enlargement (implants), NHS.
Frequently asked questions
What are the different incisions for breast augmentation?
There are three main incisions: inframammary, in the crease under the breast; periareolar, around the lower edge of the nipple; and transaxillary, in a fold of the armpit. A fourth, transumbilical (through the navel), is uncommon and used only with saline implants. The inframammary incision is the most widely used because it gives the surgeon direct access to the implant pocket. Your surgeon will recommend an approach based on your anatomy, the implant, and where you want the scar to sit.
Which breast augmentation incision leaves the least visible scar?
The transaxillary incision places the scar in the armpit rather than on the breast itself, so the breast stays unmarked, and the periareolar scar can blend into the colour change at the edge of the nipple. The inframammary scar sits in the crease under the breast, hidden in clothing and usually unseen when standing, though visible lying down. No incision is scarless: every breast augmentation leaves a permanent scar, and how it heals depends as much on your skin and aftercare as on the location.
Does the incision affect breastfeeding?
It can. The periareolar incision passes closest to the ducts and nerves beneath the nipple, so in theory it carries a slightly higher chance of affecting milk supply or nipple sensation than the inframammary or transaxillary approaches, which keep cuts away from the breast tissue. That said, breast augmentation of any kind can affect breastfeeding, and many people go on to breastfeed successfully. If feeding a baby matters to you, raise it directly at your consultation.
Does the incision affect nipple sensation?
Changes to nipple or breast sensation are a recognised risk of breast augmentation regardless of the incision, and they can be permanent. The periareolar approach runs nearest the nerves that supply the nipple, so it is sometimes linked to a higher chance of altered sensation. Numbness or heightened sensitivity is common in the early weeks and usually settles, but some change can persist. This is one to discuss honestly with your surgeon.
Which incision is used most often?
The inframammary incision, in the crease under the breast, is the most commonly used approach. It gives the surgeon the most direct, controlled access to create the implant pocket and to place silicone or saline implants of most sizes, and it keeps the cut away from the nipple and ducts. The trade-off is a scar on the breast itself, hidden in the crease but visible when lying down.
Can I choose where my breast augmentation scar goes?
To a degree. Your preference matters, but the right incision also depends on your anatomy, your breast shape, the type and size of implant, and the placement over or under the muscle. A larger silicone implant, for example, can be difficult to insert through some approaches. Your surgeon will explain which incisions suit your case and the trade-offs of each, so the decision is shared rather than purely cosmetic.
Written by Claire Ashley. Medically reviewed by Miss Charlotte Vane, MBBS, FRCS(Plast).
Our guides are written from personal experience and reviewed by a qualified clinician for accuracy. Read our editorial policy.