Breast Implant Scars: Incision Options and How They Heal

Breast augmentation with implants always leaves a scar. That is not a flaw in the surgery, it is how skin heals after any incision. What you can influence is where the scar sits, how long it is and how well it fades. This guide explains the incision options, why most surgeons favor the crease under the breast, what the scar looks like as it heals and what helps it become hard to see.

Why implants leave a scar

An implant has to be placed through an opening in the skin, and every opening heals with a scar. The incision is planned to be as short as safely possible and positioned where the natural shape of the breast, a bra or a swimsuit will hide it. The guide to breast augmentation covers the procedure itself.

The incision options

There are three common places to make the incision for a breast implant.

The inframammary fold. A short incision in the natural crease beneath the breast. The scar sits under the breast, where a bra or swimsuit covers it. This is the approach Dr. Newman typically uses, because it hides well and gives direct, precise control when placing the implant.
Around the areola. A curved incision along the lower edge of the areola, where the change in skin color can help disguise the line. It passes through breast tissue to reach the pocket.
The armpit. An incision in a natural fold of the armpit, which leaves no scar on the breast itself, but places the implant from a distance and leaves a scar that can show in sleeveless clothing.

Each approach has tradeoffs, and the right one depends on your anatomy, the implant you choose and where you would rather have the scar. A consultation is the place to talk this through.

Why the crease under the breast is the most common choice

The inframammary fold keeps the scar off the visible front of the breast and inside a crease that clothing covers. It gives the surgeon a direct view of the pocket, whether the implant goes above or below the muscle, and it avoids passing through the breast tissue behind the nipple. It also gives a convenient route back if the implant ever needs to be exchanged or removed. The comparison of implants under or over the muscle covers the pocket choice.

What affects the length of the scar

The incision only needs to be long enough to place the implant safely without stressing it or the skin edges. Implant type and size both play a part. A saline implant is usually filled after it is in place, so it can go in through a shorter opening, while a prefilled silicone implant needs a little more room, and a larger implant more still. The guide to saline and silicone implants explains the difference between the two.

What the scar looks like as it heals

In the first weeks the scar is a closed line that may look red, pink or slightly raised, with some swelling and bruising around the breast. Over the following months it gradually flattens, softens and lightens. Scars keep maturing for a year or more, so that is the point at which to judge the final appearance. For most patients the end result is a thin, pale line that is easy to forget about.

The guide to breast augmentation recovery walks through the first days and weeks, including garments, sleep and returning to exercise.

What affects how it turns out

Your skin. Some people heal with fine, flat scars. Others tend toward raised or thickened scars, and medium and darker skin tones are more likely to darken temporarily after any wound. Tell your surgeon how earlier cuts or surgery scars have healed.
Tension. A scar under tension tends to widen. Wearing your surgical bra as instructed and avoiding heavy lifting early on protect the incision while it is still weak.
Sun. A healing scar exposed to sun can darken and stay darker. Keep it covered or use a high protection sunscreen while it matures.
Smoking. Nicotine reduces blood flow to healing skin and slows wound healing.
Closure and care. Careful layered closure and following your aftercare instructions give the scar the best start.

Helping the scar fade

Simple care makes the biggest difference. Keep the incision clean and dry as instructed in the early days and wear your support bra as advised. Once the incision has fully closed, your surgeon may recommend silicone gel or sheets and gentle massage. Keep the scar out of the sun for the first year. If it becomes raised, itchy or darker than expected, mention it at your follow up, because early treatment works better than late treatment.

When a scar needs more help

A small number of implant scars heal raised, wide or darker than the surrounding skin. These can usually be improved with silicone, steroid injections, laser treatment or a small revision once the scar has matured. The guide to scar revision explains the options.

Scars after implant exchange or removal

If implants are later exchanged, resized or removed, the surgeon usually works through the existing scar where possible, so most patients do not gain a second one. If a lift is added at the same time, that adds the scars of a lift. The guide to implant removal and replacement covers revision surgery, and the guide to breast lift scars covers the lift patterns.

The short version

Breast implants always leave a scar, but it is usually short and well hidden. The crease under the breast is the most common place for it, and it is the approach Dr. Newman typically uses. The scar starts pink and fades over a year or more. Wearing your support bra, protecting the scar from sun and not smoking give it the best chance of becoming a thin, pale line that is easy to forget.

Want to know where your incision would go?

A consultation covers the implant, the pocket and the incision together, so you know where your scar would sit and what to expect before you decide.

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Yes. Placing an implant needs an incision, and every incision heals with a scar. The aim is a short scar placed where it is hidden by the natural shape of the breast, a bra or a swimsuit.

The most common place is the inframammary fold, the natural crease beneath the breast. Other approaches use the edge of the areola or the armpit. Dr. Newman typically uses the inframammary fold.

Usually short, just long enough to place the implant safely. The length depends on the type and size of the implant, so your surgeon can tell you what to expect for your own plan.

The scar is often pink or slightly raised at first, then flattens and lightens gradually. It keeps maturing for a year or more, which is the right time to judge how it will finally look.

A scar cannot be erased, but one that heals raised, wide or dark can usually be improved with silicone, steroid injections, laser treatment or a small revision once it has matured.

Often not. When implants are exchanged or removed, the surgeon usually works through the existing scar where possible, so most patients do not gain a second one.