Inframammary IncisionBreast Augmentation with an Inframammary Incision
The inframammary approach to breast augmentation surgery involves a short incision that runs within the natural fold under the breast.
If I plan to adjust the position of the fold, I will locate the incision at the level of the new fold. One example of this would be a patient with a relatively high fold who desires an implant with a larger base dimension. In order to avoid creating a “top heavy” breast, I will reestablish the level of the fold at a lower position, so that the implant is nicely centered on the breast.
The inframammary approach offers direct access to the subglandular, subpectoral and subfascial planes, the three locations where a breast implant can be placed. If I need to use advanced techniques for a particular patient, such as repositioning of the pectoral muscle, release of a tight lower breast structure, or anchoring of the fold, the inframammary incision gives the best access and allows for precision.
Another advantage of this approach is that there is minimal disruption of the breast structure. There is some evidence that this may help to diminish the likelihood of capsular contracture.
If it heals well, the inframammary incision is in some ways the least conspicuous place to put a scar. It is, after all, a natural crease. If you have a relatively light complexion and do not have any personal or family tendency to form thick scars, this can be a good choice for you.
Who should consider other options? If you like to wear very small swimsuit tops that tend to ride up above the lower edge of the breast, or if you enjoy topless sunbathing, you may want to discuss other possible incisions with your surgeon.
If you lack a well-defined fold under your breasts you might consider other incision options.
If you are of African, Southern Mediterranean, or Asian ancestry and you have a personal or family tendency to form thicker scars, it is worthwhile to discuss other incision possibilities.
If you have a relatively mature breast structure, with a well-defined fold and a little overhang of the fold, the inframammary approach tends to work very well.
PROS: Minimal disruption of breast structure; possible implications re: capsules; potentially easier recovery; best access if anything fancy to be done; in some ways the least conspicuous as long as healing is good.
CONS: Often the wrong choice for patients: of Asian and African ancestry; with a tendency to develop hypertrophic scars; who enjoy wearing teeny swimsuits or going topless; with very small breasts with minimal fold.