Which breast augmentation approach makes the most sense?


Over the past 20 years, I have had several thousand breast augmentation consultations and have been fortunate enough to have operated on most of these women. A common question that I am asked is why or why I do not use different incisions. Or why do I have a preference for one. Most of my patients are well informed and have found my practice by word of mouth and the power of the internet. My results and detail oriented personality appeals to people who are looking for the best result that they can get.

I have performed breast augmentation using all of the current popular techniques. Those being the inframammary, periareolar and transaxillary approaches.  These 3 ways have their own pluses and minuses, visit the breast implant incisions page in breast implant info section.  I have not done it two ways which, in my opinion are too risky and less likely to deliver the type of consistent breast augmentation results that my patients travel for me to deliver. The first way that I would not perform a breast augmentation is through the belly button. I have a friend in Beverly Hills that does it that way and he believes that it is fine. It is too unpredictable and not precise enough for me to use. I would not use it on my wife, so I will not use it on anyone else. It is a blind procedure in that the plastic surgeon can not see what he/she is doing and is ‘gambling’ that the equipment will be in the correct place and hopefully the muscle will be torn away just right, and that all of the bleeding that they will have will eventually stop. Since they can not see what they are doing, it is truely nothing more than an educated guess. This is not right for me or my patients. In general, it is a marketing tool that is naturally appealing to women desire no scar. The problem is when something is not correct, and a second surgery is needed (perhaps as an emergency) then the woman would have a larger scar and more expenses than they should have had if the breast augmentation was done in a more controlled fashion to begin with.  The armpit incision (transaxillary) is a good and safe incision when used with an endoscope, it is nearly equally as bad as the belly button incision because it too is a blind procedure and has the same risk profile. It too is a marketing tool that is too risky for me. In my practice which specializes in breast augmentations and secondary breast surgery revisions, I see too many women who have had problems with these two approaches.  In my mind, I like to see what I am doing, feel what I am doing, cut what and where I want to cut, and compare sides simultaneously. The inframammary or below the breast incision allows me to do this and offer breast augmentation results that my patients want and expect.