For breast augmentation, the plastic surgeon makes an incision at the bottom crease of the breast, in the armpit or along the lower edge of the areola. A fourth option, though rarely used, is an umbilical incision. This procedure uses an endoscope (a device with a light attached) for placement of the implants through the patient’s belly button.

The thinnest and least noticeable scar is the incision made in the areola. However, this site of entry can be associated with breastfeeding difficulties later on if the incision severs any milk ducts (tube-like structures that deliver milk to the nipple). Any woman who plans to breastfeed in the future may want to consider an alternative incision site.

To insert and position the implants, the surgeon lifts the breast tissue and skin, creating a pocket either under the breast tissue or under the muscle of the chest wall. Some plastic surgeons prefer placing the implants behind the chest muscle to reduce the risk of capsular contraction, where the surrounding tissue hardens around the implants. The implants are centered beneath the nipple prior to closing the incision with stitches and possibly surgical tape.

Breast augmentation surgery normally lasts one to two hours. In some cases, the surgeon will insert one or more drains (plastic or rubber tubes) into the breast or underarm area. The drains remove blood and lymph fluid that accumulates during healing. Drains usually remain in place for several days.