Is it possible to minimise scarring after breast implant surgery? Breast implants can be inserted through 3 approaches. An incision can be made in the underarm (top of hair bearing skin), at the lower edge of the areola (coloured skin around the nipple) or in the crease under the breasts. All of these incisions can heal well with minimal visible scarring if managed well. Remember that scarring is also partly genetically determined. Some patients will have increased risks of thickened scars or keloid scars and great care needs to be used in managing these scars. The goal should always be to achieve a good breast size and shape and also as inconspicuous scars as possible.

Each incision approach has advantages and disadvantages and it is important to understand these before deciding which is best for you. The underarm incision can be well hidden, avoiding any scar on the breast. However, this incision cuts through skin which is natural contaminated with bacteria and thus there is a measurable increase in infections of breast implants with the underarm incision. The incision in the lower edge of the areola can also be nearly invisible, but also cuts through skin and breast which is contaminated with bacteria, increasing the risk of infections. This incision can also damage the sensation to the nipple and areola. Because of the risks associated with these two approaches, I generally do not recommend these for breast implant surgery. The incision in the breast crease has the lowest risk of infection, enables good visualization of the pocket and nerves to the breast so that these can be protected.

Good post-operative care of scars is essential to achieving inconspicuous scars. I recommend micropore tape for 3 months before using any topical creams or gels. Various silicone gels are sold to treat scars and are of benefit after 3 months. Some scars may need LASER treatments to improve healing. Pigmented scars usually fade with time but may be improved with topical skin products and / or LASER treatments. Remember all scars take 12 to 18 months to fully heal.