Breast Augmentation Surgical Techniques

There are four main breast augmentation surgical techniques:  the Inframammary (under the breast) technique, the Transaxillary (under the arm) technique, the Transumbilical (belly button) technique, and the Periareolar (around the areola) technique.

Inframammary Breast Augmentation Technique

The most common breast augmentation procedure is the Inframammary technique, which inserts the implant in the fold where the breast meets the chest wall, leaving no visible scars.  There is less impact to milk production with this augmentation technique because neither the glandular tissue nor innervation is affected.  However, if the implant is placed on top of the pectoral muscle, it can exert pressure on the ducts and glands, which may reduce milk production functionality.

Transaxillary Breast Augmentation Technique

In order to minimize visible scarring, the Transaxillary incision technique requires placement of an incision in the extreme upper, outer region of the breast, near the juncture (“pit”) of the arm to the torso.   The incision is generally invisible even with the arm raised.  Implants are usually placed below the muscle.  The impact to milk production is usually minimal because the glandular tissue and nerves are largely undisturbed.  As with the other incision techniques, placement of the implant above the muscle will result in greater impairment than placement underneath.

Transumbillical Breast Augmentation Technique

The Transumbilical incision technique, commonly called Transumbilical Breast Augmentation (TUBA), is performed by inserting the implant through an incision in the umbilicus (navel) and moving it into place in the breast. In this technique, no incisions are made on the breast or into the breast tissue, although the breast tissue is disrupted and sometimes damaged as the implant is brought into position. Insertion through the umbilicus makes it difficult to position the implant accurately, requiring the use of a camera scope.  It also permits placement only above the muscle.  Like the Transaxillary incision technique, the Transumbilical incision technique preserves glandular function and nerve response so that the impact to milk production is usually minimal.  As with the other incision techniques, placement of the implant above the muscle will result in greater impairment than placement below.

Periareolar Breast Augmentation Technique

The Periareolar Incision technique requires an incision around the areola. It is often used by surgeons to hide scarring.  Placement of the implant in this location results in considerable duct, glandular, and nerve damage, carrying significant risk to milk production. Ducts and glands are likely to be severed because the incision penetrates deeply through the breast tissue.  If the implant is placed above the muscle, it may further impede milk production functionality by placing pressure upon the glandular tissue.