Good question, and the answer is not simple. Surgeons are always looking for ways to improve patient outcomes. This has led to the development of remote incision placements to better hide scars associated with placing an implant for breast augmentation. The most popular and most used incisions are either placed near the fold under the breast or through the edge of the lower areola. These incisions provide for direct access to the breast allowing for the surgeon to have the greatest chance for success in creating the proper pocket for implant placement. Also, these incisions allow for easier control of potential bleeding. Larger sized implants are much easier placed through and incision under the breast or under the nipple.
The next popular approach for placement of breast implants is through the axilla (arm pit). The scar from this approach is nicely hidden so that there are no scars on the breast. Creation of a proper pocket for the implant is difficult because direct vision of the tissues is difficult. Although some surgeons have been successful with this approach, I find that it often leads to a pocket that is too lateral resulting in separated breasts and poor cleavage. To improve the chances for success, I recommend the assistance of video endoscopy to create the best pocket and to control possible bleeding.
A novelty that I believe is losing popularity is the umbilical approach. Few surgeons have found this to be successful because it is a completely blind procedure. Pocket placement and control of possible bleeding are extremely difficult. I believe that placement of silicone breast implants is impossible through this approach.
Ultimately, choose the approach that you believe will give the best result, but make sure your surgeon is experienced with this technique.
For more information on Breast Augmentation or to schedule a consultation contact Dr. Gallegos.