1 - Length: With a salt water prosthesis, the required incision is 3 cm, regardless of the size of the prosthesis, because the prosthesis is empty when it is inserted. With a silicone gel prosthesis, the required incision is at least twice as long, and sometimes longer, depending on the size de the prosthesis, because the prosthesis is full when it is inserted.
2 - Location: Although the scar caused by the incision is usually difficult to see, it is sometimes more visible than expected. Therefore, the location of the incision may be important. The incision can be made in the following locations: mammary fold, armpit, nipple, navel.
a - Mammary fold: This is the most common location. The incision is hidden in a natural fold, and is easily hidden by a bra. This location allows the surgeon to create the cavity where the implant will be placed with his fingers, and affords optimal control during the procedure. In the case of a secondary procedure, the incision must often be made in this location, even if the initial incision was elsewhere.
b - Armpit: The incision is also hidden in a natural fold, but in an area that is more exposed to view than the mammary fold if the scar is visible. It is widely understood that a scar in the armpit often signifies breast enhancement surgery. In addition, the incision is far from the site of the implant, and does not allow the surgeon to create the cavity where the implant will be placed with his fingers (specialized instruments must be used). With this approach, the risk of not having the prosthesis in the ideal position are elevated, with the prosthesis being placed too far to the side, because it is inserted from the side, or with differences in location between the two breasts. In the case of a secondary procedure, it may be necessary to make the second incision in the mammary fold.
c - Nipple: The incision is hidden in the natural border of the areola, between the brown and white areas. This area, which is shaded, may present a clearer border because of the scar. If the scar pulls, this can sometimes distort the roundness of the nipple. This incision location may also increase the risk of decreased sensitivity of the nipple. However, this approach is more desirable when a procedure involving the areola is required (e.g.: reduction of an excessively large areola).
d - Navel: A 3-cm incision in the navel cannot be completely hidden. In addition, it is not hidden in a natural fold, as with the other approaches. It is harder to hide the scar under clothing, especially given current styles, which often leave the area around the navel uncovered. The incision is very far from the site of the implant, and requires sophisticated instruments that make this technique more time consuming and more difficult, especially in the case of sub-muscular implants, with no offsetting advantages. A secondary procedure cannot be carried with an incision in the same location.