Breast Augmentation — Understanding Implant Choices and Incision Methods
Breast augmentation is a procedure that enhances breast volume by inserting materials such as saline-filled implants, cohesive gel implants, or autologous fat through incision approaches such as the armpit or areola, placing the material above or below the muscle. Recovery and aftercare can vary depending on the material chosen and the surgical approach, so it is important to understand the characteristics of each method before surgery.
Kim Jongseo Plastic Surgery in Apgujeong has used only MENTOR implants since 2001. This article summarizes the specific materials, incision methods, and the differences depending on implant placement. You can find our detailed treatment philosophy on the About the Doctor page.
What types of implants are used for breast augmentation?
Three main types of materials are used. First, saline implants are filled with saline solution during surgery, allowing size adjustment and requiring a smaller incision, though the texture can feel somewhat less natural. Second, cohesive gel implants are a type of silicone gel with cohesive, shape-retaining properties, meaning that even if ruptured, the gel does not leak outward, and they provide a texture similar to natural breast tissue. On July 18, 2007, they were designated as a tracked medical device by the Korea Food and Drug Administration and approved for domestic sale. Third, autologous fat grafting uses the patient's own fat tissue, offering the combined benefit of liposuction and breast augmentation; however, since it is difficult to achieve as much volume increase as with implants, it is generally recommended to plan for 2–3 sessions in advance.
Where is the incision made?
There are four incision approaches. The armpit (axillary) incision is suitable when the areola is small, and there may be some pain when moving the arm for about the first week. The areolar incision has the advantage of leaving minimal scarring since the areola consists of mucosal-like tissue, and it offers good surgical visibility, making revision surgery relatively more accessible if needed. The inframammary fold incision is commonly performed in Western countries but is less preferred among Asian patients due to concerns about visible scarring. The navel (transumbilical) incision is only possible when using saline implants, which can be folded and inserted empty through a small opening; the bulkier cohesive gel implants cannot be inserted through this approach.
Are implants placed above or below the muscle?
Placement above the muscle is generally considered when paired with cohesive gel implants for their natural feel, allows the breasts to be brought closer together more easily, and tends to involve relatively less pain and bleeding. However, when placed above the muscle, the implant may be somewhat more noticeable to the touch, and if capsular contracture occurs, a firmness may be more easily felt. Placement below the muscle was conventionally performed often in the past due to a belief that it reduces the occurrence of capsular contracture, and armpit incisions are typically paired with submuscular placement. Submuscular placement tends to involve somewhat more pain, and the implant may shift when moving the arm, with some limitation in how close together the breasts can be brought. The appropriate placement depends on each individual's condition and is determined through consultation.
What is the pain and recovery like after surgery?
Because a local anesthetic is administered to the surgical area, pain on the day of surgery tends to be minimal, and discomfort may begin the night the anesthesia wears off. Patients are typically discharged with an IV line still in place and guided on how to manage pain and pace their recovery at home. The cohesive gel implant with areolar approach tends to involve less pain, and a relatively quick return to daily activities after same-day discharge can be expected, though recovery speed varies by individual. With the areolar incision, nipple sensation may temporarily decrease, generally recovering gradually after about 6 months, and with the armpit incision, a reduction in sensation of about 10–20% may also be observed. It is helpful to understand that some degree of sensory change can occur with breast surgery in general.
Does this affect pregnancy, breastfeeding, or breast cancer screening?
Because implants are placed beneath the mammary gland, they are explained to have little direct effect on pregnancy or breastfeeding. However, approximately 10% of the mammary gland tissue may be affected during surgery, so if you are planning to breastfeed in the future, please discuss this thoroughly with your specialist during consultation. Silicone implants are placed beneath the mammary gland or muscle and are explained not to significantly interfere with breast cancer screening; however, if you have had fat grafting, this can interfere with the interpretation of screening results, so it is important to inform your medical team of any prior fat grafting before your examination.
Consultation Information
Kim Jongseo Plastic Surgery (Apgujeong, Seoul) · 2F Apgujeong Building, 842 Nonhyeon-ro, Gangnam-gu, Seoul · 02-3416-0070 (after hours 070-4027-0070) · Book a Consultation
This article is provided for informational purposes only, and the effects and recovery period of any surgery or procedure may vary by individual. All medical procedures carry a possibility of side effects, so please consult thoroughly with a specialist.
Procedure Detail Materials
Below are procedure guide materials from the previous website (surgery.co.kr). Before-and-after results may vary by individual, and all medical procedures carry a possibility of side effects.
