PROCEDURE GUIDE

Breast Augmentation
Incisions and Scars

While the most important question a patient can ask might be “what are the risks of a breast augmentation surgery?” one of the most common questions we get is “will a breast augmentation leave a scar?” No matter the procedure, patients are understandably concerned with the likelihood of scarring and ways to reduce the appearance of scars. And while any surgery typically creates scarring, there are a lot of ways to make them less noticeable.

Will a breast augmentation leave a scar?Breast augmentation scars largely depend on the type of augmentation surgery you have and the surgeon’s implant placement. Immediately after surgery, scars are more visible and may take on a darker hue. About 18 months after surgery, most patients start to see the final scars – these may be slightly pink or light white in colour.

Avoiding scars is usually a patient’s number one concern, but do you know the science behind them?Once the surgeon makes their cuts, our body delivers collagen to the incision site. It dumps the collagen into the injury site without organizing it very well. The collagen fibres are laid down haphazardly, usually resulting in a scar that is raised or bumpy.
Over time, the collagen fibres begin to work together and lay in the same direction. When this occurs, the scar heals and becomes less noticeable.

Where will my breast augmentation scars be located?
There are several incision types for breast augmentation procedures, and the type you’ll receive will depend on the surgical approach selected. The most common types include transaxillary, periareolar, inframammary, and lollipop or anchor.

Breast augmentation scar locations:
ArmpitTransaxillary Breast Augmentation: A transaxillary breast augmentation is when the implant is placed through an incision in the armpit. This is one of the most popular incision sites for a breast augmentation. Once healed, the 1” scar will become virtually invisible. Typically, these scars are indistinguishable from an armpit wrinkle.
Here is an example of our work with minimal scarring: Transaxillary breast augmentation. Hiding the scar in the armpit in the correctly selected patient makes it a virtually ‘scarless’ breast augmentation.
Breast fold – Inframammary Breast Augmentation: Another common incision for breast reconstruction is the inframammary fold, in which the implant is placed inside the crease below the breast. The procedure is normally hidden by the breast and can be reused if you ever remove or replace your implants. This placement is typically only recommended for patients with a well defined breast fold.Here are a couple examples of our skill concealing scars using inframammary cuts:
Areola – Periareolar Breast Augmentation: In a periareolar breast augmentation the implant is placed through an incision around the areola. These scars tend to blend in extremely well and allow for the implant to be easily accessed in the future should the need arise.
This placement is less common, because the scar is not hidden in the same way a inframammary or transaxillary would be.
Areola – Lollipop or Anchor Breast Augmentation: Mostly used for a breast lift rather than breast augmentations with implants, the surgeon will make an incision around the areola, and then down the centre of the lower breast. This is called a lollipop incision.
Here’s an example from one of our patients.
In cases that require more lift or tissue removal, the lines is continued along the breast fold as well. When this happens, it is called an anchor incision.
Will my breast augmentation scars be noticeable?A permanent scar remains after surgery where each incision was placed. The SixSurgery team are experts at creating minimal scars that are beautifully concealed and virtually undetectable. The technique that is chosen for your surgery will therefore depend on:
Your existing breast anatomy
Personal goals
The content of your breast implants (saline or silicone)
The profile and size of your breast implants
The intended position of your breast implants (above or below the chest muscle)
It is important to remember that the final appearance of your scar depends largely on the placement of the incision and your adherence to your post operative instructions. Typically, breast augmentation scars heal very nicely, and will be virtually invisible once the healing process is complete. Breast augmentation scars aren’t usually noticeable life, and as they are only a few inches long and are placed in areas that allow them to be hidden. Most patients see their final scars about 18 months after healing and usually appear light pink or white in colour.

Sometimes, breast augmentation scars can heal incorrectly due to your surgeons work or a patient incorrectly following post operative instructions. The scars may also be more noticeable on certain skin tones, or if a patient is prone to keloid or hypertrophic scars. It is helpful to note the way your skin heals naturally after you get a scrape, and take this into consideration when planning for surgery scars. If after 18 months, your scarring is very visible or if you’re not happy with how they look, you can contact your surgeon to go over your options for a scar revision procedure.

It is possible that your breast enlargement may be suitable for more than one approach, in which case, you will be able to decide where you would prefer your scars to be concealed.
What is a “Tiny Scar Breast Augmentation”Dr. Jugenburg and the team of surgeons at the SixSurgery Clinic have coined the term “Tiny Scar Breast Augmentation” to describe the procedure that has many patients flocking to their clinic.

“Typical scarring from breast implants are 4-8 cm., Dr. Jugenburg’s innovative approach accomplishes just a 2 cm incision for saline implants and a 2.5-3 cm incision for silicone implants.”

The most common Tiny Scar Breast Augmentation that Dr. Jugenburg performs is a saline implant through a transaxillary incision. These implants are rolled up tightly before insertion, and are only filled with saline once placed in the breast cavity, allowing for the smallest scars possible. Once the 1-2” scar is healed, it is indistinguishable from an armpit wrinkle. These procedures are virtually bloodless, and are accomplished in about 30 minutes.
How can I minimize scars after a breast augmentation?Scar healing is an intricate and gradual process. There are many things you can do to help minimise the appearance of scars and speed up the healing process:
Follow your plastic surgeon’s physical activity guidelines after breast augmentation
Eat nutritious foods and stay hydrated during recovery
Avoid smoking for a few weeks before or after the procedure
Stay out of the sun once the surgery is complete
Also, using topical creams and ointments, wearing compression garments, and sleeping on a comfortable mattress can impact the healing process.

Check out one of our patients about scar healing:
What are my scar treatment options?Scar treatment options depend on the severity of the scars and how you feel about them. In some cases, the scars may fade over time with the help of natural remedies or treatments.

After consulting with your surgeon to get their thoughts, here are a few options for you:
Cortisone cream for the skin
Vitamin E – supplementation or applying topical cream
Silicone sheeting
Laser skin resurfacing
Breast augmentation is a popular procedure that can result in beautiful, natural-looking breasts. If you’re considering this for yourself, it’s important to choose a qualified plastic surgeon who will be able to properly hide your scars, which will give you more confidence and will help speed up the healing process.
Does your choice of Plastic Surgeon have an impact on your scars?Many breast augmentation patients are anxious about the appearance of their scars. Choosing a qualified plastic surgeon, like any member of the SixSurgery team, can ensure you receive the best possible results.

A skilled surgeon will know which incision is most ideal for your specific case, and will take steps to minimise the appearance of any scars for your unique appearance.

Listen to what her patients are saying about one of our surgeons, Dr. Rose:
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“…My results are more than I expected. Dr. Rose and the team at the Toronto cosmetic clinic were always helpful and professional. The After care nurses were also amazing. Dr. Rose had several follow ups with me over the past 11 months and answered all questions and genuinely cares. Thank you for being such an amazing surgeon Dr. Rose and for being a kind and caring person!” ~Lisa Shapko

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“…Dr Rose is calming, professional and is very detail oriented. I wanted a place that would make suggestions and guide me throughout the process but also listen to my wants and desires she did that and more. The post -op care has been just as detailed and amazing as the pre-op. The nurse’s respond 24 hours a day and guide you through the healing. They are compassionate and very quick to help you out day or night. I would 100% recommend Dr. Rose and the team.” ~Kerri E.

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…From the 1st email, to the last appointment Dr.Rose was the best of the best. I felt I was getting special attention. She made sure I was happy with the size, the product I was getting.

The pros and cons about the surgery. She didn’t forget any detail. If I can recommend her to every women in the the world I would. Being treated by her was an honour…” ~Salete Silva

Trans-Axillary Breast Augmentation

An incision is made in the armpit and a tunnel is then created into the space (the breast pocket) under the chest muscle. This approach is the best way to hide the scars; there are no scars on or under the breasts, and the scar in the armpit heals beautifully to a point where it is undetectable to the naked eye. For this reason, the Trans-Axillary technique can be described as a virtually scarless Breast Augmentation and is the preferred approach of the SixSurgery team..
Ideally healed transaxillary scar looks like a wrinkle in the armpit

Peri-Areolar Breast Augmentation

A small incision is made around the lower border of the areola. This is an effective way to conceal the scar, especially in women who have a more pronounced contrast between the color of the areola and skin.

Peri-Areolar surgery is preferable in women who do not have a well defined breast fold and in whom an Infra-Mammary incision would therefore be difficult to hide.
PeriAreolar breast augmentation scar seen 2 years after surgery
Periareolar scar seen after 4 years. Over time the skin discoloration around the actual incision faded, and the incision itself is a very fine barely visible line.

Infra-Mammary Breast Augmentation

A small incision is made within the breast fold, providing direct access and easy implant placement into the pocket either above or below the chest muscle.

This is the most popular approach to Breast Augmentation (for women having a well defined breast fold).
#tinyscar breast fold incision is the smallest possible incision for breast augmentation
An example of a slightly thickened, raised breast fold scar. It will benefit from Kenalog injections.

Trans-Umbilical Breast Augmentation

A small incision is made inside the belly button. A narrow tube is then temporarily placed under the skin towards the breast, through which a surgical instrument is inserted to create the pocket for the implant. A saline implant is then folded up and inserted through the tube into the pocket under the breast.

Dr. Jugenburg does not perform this approach because of its obvious limitations.

Breast Implant Scars FAQ

What are the breast implant size limitations of the different incision placements?
Silicone breast implants, which come in pre-filled profiles and sizes, require longer incisions than saline implants. Saline implants are filled after insertion under the breast area resulting in a smaller incision. (i.e., once inside the breast). Larger silicone implants can be problematic for the Trans-Axillary approach; however, this will depend on the anatomy of each patient.
Will you use the No-Touch Technique to insert my breast implants?
All Breast Augmentation procedures are performed using the No-Touch Technique. Using this technique, breast implants are transferred from their sterile packaging directly into the breast pocket to minimize the risk of bacterial contamination and therefore, Capsular Contracture formation. For further information, please refer here.
Will my procedure be a Bloodless Breast Augmentation?
The Bloodless Breast Augmentation technique, which is believed to lower the risk of Capsular Contracture, is useful for surgery performed through the areola (Peri-Areolar) or breast fold (Infra-Mammary), but is not compatible with surgery performed through the armpit (Trans-Axillary). For further information, please refer here.
Are there any treatments that can be used to minimize my scars?
In addition to the SixSurgery team ‘s  expertise at creating beautifully concealed, virtually undetectable scars, we sell the silicone-based skin gel Strataderm to all our patients. Although vitamin E, Bio-Oil and other products are available over the counter, silicone creams and gels are the only substances shown to be effective in scientific studies for surgical scars.
How long will my scars be?
The average length of incision is 3 – 4 cm (1 – 1.5 in), but the length of your scars will depend on your chosen breast implant profile, size and type. Saline implants of all sizes typically require very small incisions, whereas silicone implants require longer incisions and a skilled Plastic Surgeon, such as the SixSurgery team, to effectively conceal them.
What will my scar look like?
Following surgery, Breast Augmentation scars are red and normally a little raised, but over 3 – 6 months they usually fade and flatten out, becoming thin, barely visible lines. For all incision placements, the scars are usually beautifully concealed within the natural contours of a woman’s body.
Are some women more prone to visible scarring?
All scars are visible initially following surgery.
Past scarring from previous injuries and/or surgeries may be indicative of how prone an individual may be to visible scarring and can influence the decision on where best to make the incisions during Breast Augmentation surgery.
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