If you would rather not have a scar on the front of your body, the armpit (transaxillary) approach has the edge; if asymmetry or sagging needs fine correction, the breast-fold (inframammary) approach is usually better. The armpit approach leaves no scar on the breast itself, but arm movement can feel restricted early on. Here is how the two approaches differ and which suits which breast. What is the armpit incision?
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What is the armpit incision?
A 2–3 cm opening is made along a natural crease inside the armpit and the implant is placed through it. Because the wound follows an existing crease, it is hard to see when the arm is down.
Since the entry point is some distance from the breast, the pocket is created under endoscopic guidance.
What is the breast-fold incision?
The incision follows the crease under the breast and the implant is placed through it. The incision sits close to the pocket, giving a wide view and allowing precise adjustment of implant position and fold height.
The scar may be visible when lying down, but it gradually fades over time.
In a study that assessed breast augmentation scars with the SCAR-Q questionnaire, breast-fold scars caused less psychological burden than periareolar scars, and scar perception improved further by 6 months.[1]
How do the two approaches compare at a glance?
| Item | Breast fold | Armpit |
|---|---|---|
| Surgical view | Easier to see the pocket | Relatively limited |
| Scar location | Under-breast crease | Armpit crease |
| Position control | Easier to fine-tune | Can be more technically demanding |
| Early recovery | Relatively faster | Arm movement may feel restricted |
The difference in recovery comes from the dissection distance. The armpit approach creates a long tunnel from top to bottom, so lifting the arm can feel stiff or tingly at first. Keeping the arms out to the side for over an hour during surgery also contributes, and this usually settles over time.
In a study comparing 364 patients who received the same implants, complications were 1.8% with the breast-fold approach and 2.7% with the endoscopic armpit approach — not a significant difference.[2]
When is the armpit incision a good fit?
It is worth considering when there is little or no sagging and the breast fold is not well defined. It is also why the armpit approach is often mentioned for people who do not want a visible scar on the front.
Related readingHow to choose between the breast-fold and armpit incisions is covered in “Faster-Recovery Fold vs Hidden Armpit Scar: Which Breast Augmentation Incision Suits You?” (Korean).
When is the breast-fold incision a good fit?
It is the better choice when the breasts differ in size or height, or when sagging or pseudoptosis means the fold position must be reset. Because the pocket can be seen and shaped directly, the range of correction is wider.
Breast augmentation incisions: common myths and facts?
| What many people think… | What the evidence shows |
|---|---|
| “The armpit incision has more complications.” | Studies found no difference in complications between the breast-fold and armpit approaches. |
| “Breast-fold scars are very noticeable.” | They sit hidden in the under-breast crease and caused less psychological burden. |
| “The incision site doesn’t matter.” | The right incision depends on implant size, chest shape and the extent of correction needed. |
In incision consultations, I first check whether the under-breast crease is well defined. In bodies with almost no crease, a breast-fold scar has little to hide in, so the armpit approach may be better.
Rather than choosing by scar location alone, consider breast shape, the degree of asymmetry, skin and tissue condition and your daily habits together. If your work or exercise involves heavy arm use, factor in that arm use may be limited during early recovery.
🔬 Supporting research
Peer-reviewed international journal articles that support this article. Click a title to open the PubMed abstract.
- Aesthetic Plastic Surgery 2024 — SCAR-Q scar assessment Impact of Incisional Access Site in Primary Breast Augmentation: Evaluation of Patient Satisfaction with SCAR-Q. Key finding: breast-fold scars caused less psychological burden than periareolar scars In text [1] · PMID 37495729 · DOI
- Aesthetic Plastic Surgery 2019 — Endoscopic armpit vs breast-fold, 364 patients Endoscopic Transaxillary Versus Inframammary Approaches for Breast Augmentation Using Shaped Implants: A Matched Case-Control Study. Key finding: complications 2.7% vs 1.8%, no significant difference In text [2] · PMID 30911772 · DOI
🎬 Watch — Dr. Park Seong-Soo · BongBong Plastic Surgery
Related videos from BongBong Plastic Surgery's official channel and Dr. Park Seong-Soo's channel. Videos are in Korean and play on YouTube.
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0:40 Why the breast-fold incision is so commonly used (Korean) Dr. Park's channel · 2025.09.28 -
1:00 From implant lifespan to incision site: 2 questions everyone asks (Korean) Dr. Park's channel · 2026.03.07 -
6:45 Breast augmentation incisions: which are you considering? (Korean) Dr. Park's channel · 2025.09.24
Frequently asked questions (FAQ)
Will the armpit scar show later?
Because the wound sits inside a crease, it is hard to see with the arm down. It may show when the arm is raised, and how quickly the scar matures depends on your skin type.
Is arm tingling after surgery a warning sign?
Arm tingling is often a temporary effect of the arms being held out for a long time during surgery. It usually resolves over time, but see your surgeon if it gets worse or if one side becomes noticeably more swollen.
Can I have the armpit approach if I have asymmetry?
If the asymmetry is mild, it may be possible. But if the fold height itself differs between sides, the breast-fold approach makes it easier to match positions, so it is worth comparing both in consultation. Where the scar goes and how finely the shape must be refined are separate questions. With little sagging or asymmetry, hiding the scar in the armpit is a reasonable choice; if the fold needs to be reset, the breast-fold approach makes the result easier to control. If you use your arms a lot, weigh early recovery as well.
Is there a difference in complications between the two incisions?
In a 364-patient study using the same implants, complications were 1.8% for the breast fold and 2.7% for the armpit — not a significant difference.
📖 References
Click a [number] in the text to jump to its source, and ↩ to return. Only papers whose title, journal and year were verified on PubMed are listed.
- ↩ Gratteri M, Marangi GF, Mirra C, et al. Impact of Incisional Access Site in Primary Breast Augmentation: Evaluation of Patient Satisfaction with SCAR-Q. Aesthetic Plast Surg. 2024;48(8):1565-1570.PMID 37495729 · DOI— SCAR-Q scar assessment — breast-fold scars caused less psychological burden than periareolar scars
- ↩ Lee DW, Kim SJ, Kim H. Endoscopic Transaxillary Versus Inframammary Approaches for Breast Augmentation Using Shaped Implants: A Matched Case-Control Study. Aesthetic Plast Surg. 2019;43(3):563-568.PMID 30911772 · DOI— Endoscopic armpit vs breast-fold, 364 patients — complications 2.7% vs 1.8%, no significant difference
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