Introduction
Breast augmentation is one of the most sought - after cosmetic procedures worldwide, and New York City stands at the forefront of this surgical trend. The year 2025 continues to see an increasing number of individuals seeking breast augmentation surgery in the city's numerous Grade - A or private medical facilities. A crucial decision in breast augmentation is the choice of incision. The incision not only affects the aesthetic outcome of the surgery but also the recovery process and potential complications. This article will explore the different types of incisions for breast augmentation surgery in New York City, rank them based on various factors, and provide in - depth information to help patients make an informed decision.
Overview of Breast Augmentation in New York City
According to the American Society for Aesthetic Plastic Surgery, breast enlargement has consistently ranked in the top three of all cosmetic surgery procedures year after year. In New York City, the demand for breast augmentation is high, with patients ranging from young women who feel their breasts are too small to those looking to restore volume after pregnancy, weight loss, or due to the aging process. New York City is home to many world - class plastic surgeons and state - of - the - art medical facilities, offering patients a wide range of options for their breast augmentation journey.
There are several leading plastic surgeons in New York City, such as Dr. Francesco Gargano, Dr. Adam Schaffner, Dr. George Lefkovits, and many others. These surgeons are board - certified and have extensive experience in performing breast augmentation surgeries. They are well - versed in the latest techniques and can guide patients through the entire process, from the initial consultation to the post - operative care.
Types of Incisions for Breast Augmentation
Inframammary Incision (In the Breast Crease)
The inframammary incision is the most commonly used incision pattern for breast augmentation. As described in the source "Best Incision and Placement Options for Breast Augmentation NYC | Steven Wallach MD, FACS", this incision results in a scar in the crease under the breast, where it is easily concealed.
Advantages
- It provides very good access to visualize the pocket and to treat bleeding points. Surgeons can precisely create the implant pocket, which leads to higher precision and better results with a low risk of complications.
- Either saline or silicone gel implant placement is possible through this incision, giving patients more flexibility in their implant choice.
Disadvantages
- The scar can be more noticeable because of stretching, especially if the patient gains or loses weight after the surgery. In some cases, tattooing may be required to camouflage the scar.
- There is a slightly higher tendency for the inframammary fold to be undermined and create a deformity known as the “double bubble”.
Periareolar Incision (Around the Areola)
In some cases, an incision can be made in the transition from the areola to the breast skin. Due to the change in pigmentation, this incision is not easily seen, as per the information from Steven Wallach MD's articles.
Advantages
- The final scar usually blends in well with the change in color from the areola pigment to the surrounding breast skin. This makes the scar less visible compared to some other incisions.
- Surgeons have good visualization of the pocket, which allows them to treat many breast deformities and asymmetries during the surgery. They can also design the pocket, treat bleeding points, and divide the pectoralis muscle if placing implants in a subpectoral pocket or creating a subglandular pocket.
Disadvantages
- Sometimes the scar is noticeable and may require scar care to better camouflage the incision. This can add additional time and cost to the post - operative care.
- If the areola is too small, it may not be of adequate size to allow for the placement of a saline or silicone gel implant. Saline implants can be placed through a smaller areola than silicone breast implants.
Axillary Incision (In the Armpit)
An axillary incision is an approach where an incision is made in each underarm, creating a pathway to the breast tissue to avoid leaving any visual scar on the breast itself.
Advantages
- The most significant advantage is that the scar is not on the breast, which can be appealing to patients who are very concerned about visible scars on their breasts.
Disadvantages
- The scar can be noticeable when the patient raises their arm. It may also require tattooing to camouflage it better.
- This approach is more likely to result in bad positioning of the implant, especially when performed without endoscopic visualization. It can also be difficult to gain control of potential bleeding sources from this remote access.
- Placing silicone breast implants through an axillary incision can be very difficult.
Transabdominal Breast Augmentation (TABA)
In rare cases, patients may be eligible for an incision in the upper abdomen, perhaps when combined with an abdominoplasty or tummy tuck.
Advantages
- There are no incisions on or near the breast during this breast augmentation surgery, which can be a major advantage for patients who want to avoid breast - related scars.
- There is usually good visualization of the pocket and bleeding points, and both saline and silicone breast implants can be placed through this incision as an adequately sized tunnel from the upper abdomen to the chest is created.
Disadvantages
- This kind of breast augmentation surgery is only performed in women without significant ptosis (drooping) of the breast and who also desire a full tummy tuck. So, it has a very limited candidate pool.
Transumbilical Breast Augmentation (TUBA)
A transumbilical incision utilizes an incision in the belly button rather than one on the breasts, but it is not often performed anymore.
Advantages
- There are no incisions on or near the breast during this breast augmentation surgery.
Disadvantages
- It is difficult for the plastic surgeon to visualize the breast implant pocket. If there is any bleeding, an inframammary or periareolar incision needs to be performed to gain access for treatment.
- Saline implants are the only type of implants that can be placed through this incision; therefore, silicone gel implants cannot be used with this approach.
Ranking of Incisions
Based on Visibility of Scars
- 1st Place: Transabdominal Breast Augmentation (TABA) and Transumbilical Breast Augmentation (TUBA): Both these incisions result in no scars on or near the breast. TABA has an abdominal scar which can be hidden under clothing, and TUBA uses the belly button as the incision site, making it a great option for patients extremely concerned about breast - visible scars.
- 2nd Place: Periareolar Incision: The scar around the areola usually blends well with the color change, making it less visible compared to some other incisions.
- 3rd Place: Inframammary Incision: Although it is in the breast crease, stretching can make the scar more noticeable, especially in some circumstances.
- 4th Place: Axillary Incision: The scar can be visible when the arm is raised, which limits its appeal in terms of scar visibility.
Based on Surgical Precision and Implant Placement
- 1st Place: Inframammary Incision: It provides excellent visualization of the pocket, allowing for precise implant placement and better control of bleeding points. This leads to a lower risk of complications and more accurate results.
- 2nd Place: Periareolar Incision: Surgeons can also have good visualization and are able to treat various breast issues during the surgery, making it a reliable option for implant placement.
- 3rd Place: Transabdominal Breast Augmentation (TABA): With good visualization of the pocket and bleeding points, it allows for the placement of different types of implants, but its use is restricted to a specific group of patients.
- 4th Place: Axillary Incision: This approach has a higher risk of bad implant positioning, especially without proper visualization.
- 5th Place: Transumbilical Breast Augmentation (TUBA): The difficulty in visualizing the implant pocket makes it challenging for precise implant placement, and its use is limited to saline implants.
Based on Implant Options
- 1st Place: Inframammary Incision: It allows for the placement of both saline and silicone gel implants, giving patients the most flexibility in their implant choice.
- 2nd Place: Transabdominal Breast Augmentation (TABA): Similar to the inframammary incision, it can accommodate both types of implants.
- 3rd Place: Periareolar Incision: Can be used for both types of implants, but the size of the areola may be a limiting factor for silicone implants in some cases.
- 4th Place: Axillary Incision: Placing silicone implants is very difficult through this incision, mainly restricting the option to saline implants.
- 5th Place: Transumbilical Breast Augmentation (TUBA): Only saline implants can be placed through this incision.
Other Considerations in Incision Choice
Patient's Body Type and Breast Characteristics
Patients with smaller areolas may not be suitable candidates for periareolar incisions. Those with significant breast ptosis may not be eligible for TABA. The amount of natural breast tissue also plays a role. For example, patients with little natural breast tissue may benefit more from certain incisions in combination with submuscular implant placement, as discussed in relevant sources about breast augmentation.
Surgeon's Experience and Expertise
Some surgeons may be more experienced with certain incisions. For instance, a surgeon who has performed many axillary incisions may be able to achieve better results with this approach. It is important for patients to choose a surgeon who is proficient in the incision method they prefer.
Patient's Lifestyle and Expectations
Patients who are very active and have concerns about visible scars during physical activities may lean towards incisions that are less visible, such as TABA or TUBA. Those who want more precise control over the aesthetic outcome and are willing to accept a more visible scar may choose the inframammary or periareolar incisions.
Conclusion
Choosing the right incision for breast augmentation surgery in New York City in 2025 is a complex decision that involves weighing multiple factors. Each type of incision - inframammary, periareolar, axillary, transabdominal, and transumbilical - has its own set of advantages and disadvantages. The ranking of these incisions can vary depending on whether the focus is on scar visibility, surgical precision, or implant options.
Patients considering breast augmentation should consult with a board - certified plastic surgeon in New York City. Surgeons can assess the patient's individual body type, breast characteristics, and lifestyle, and then recommend the most suitable incision method. By making an informed decision, patients can achieve the best possible aesthetic outcome and a smooth recovery process.
If you are considering breast augmentation, take the first step and schedule a consultation with a qualified plastic surgeon in New York City. Learn more about your options and start your journey towards achieving your desired breast appearance.
