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Implant Incision Pattern

Conveniently located to serve the areas of Maryland, Virginia and Washington, D.C.

Incision Patterns We Use

A large goal of breast augmentation is to make the incision as concealed as possible. The 2 possible incision spots we use at CSA are around the nipple and the natural crease of the breast. About 90% of our patients receive Inframammary incisions, while the remaining 10% get Periareolar incisions. Although there may be slight visibility of scarring, they tend to blend in and fade over time. The amount of visibility varies from patient to patient. Skin color and texture play a part in this.

You don’t need to make this decision on your own. We will help you decide the best incision pattern during your consultation. After having performed countless amounts of these procedures, we at Cosmetic Surgery Associates know what works best for our patients.


This incision is made around the lower half of the areola. This is a common implant incision spot if you are combining a breast augmentation with another procedure such as an areola reduction or breast lift. There is some swelling associated with this incision, but this will subside and scarring eventually fades into the areola. Scarring is often very subtle.


This incision is made under the breast in its natural crease. There are advantages with a breast crease incision. This incision allows one of our board certified doctors to easily reach the pectoral muscle to place the implant underneath. Less swelling and tissue disturbance is involved with this incision placement.Scarring is minimally visible because it will naturally blend in and fade with the breast fold.

Our Philosophy

It is our philosophy at Cosmetic Surgery Associates that Periareolar and Inframammary incisions are the two best choices out of the other possibilities.

These incisions allow the surgeon to visualize the breast pocket. When inserting the implants, surgeons need to release the accessory muscle fibers of the pectoralis muscle. If they fail to do this, the implants sit wide on the chest and there will be a large gap between the breasts.

Incisions in the underarm or through the belly button do not allow the surgeon to visualize the pocket, and the accessory muscle fibers don’t always get released because they are inserting the implants blindly. This will cause the breasts to appear very wide on the chest, leaving an unsightly cleavage gap. We take great care to assure this is will not happen and make sure results are as natural-looking as possible, unless the patient desires otherwise. This is why we only use Periareolar and Inframammary incisions because using these two will help ensure the most natural-looking results.


Patient Reviews

Dr. Franklin D Richards was BEYOND amazing! I can’t stress enough how great this whole experience has been. Not only did he make me feel comfortable in my body, but 10x more confident. His work is truly beautiful. 100% recommend!!

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Our Special Pain Reducing Technique

We’ve developed a special technique at Cosmetic Surgery Associates that dramatically reduces pain after breast augmentation and shorter recovery. A patient can have surgery on Friday and go back to work on Monday. Some patients don’t even need to take any pain medication because of the minuscule pain associated with this technique.

To learn more, please read our article published in the Aesthetic Surgery Journal.

Our Plastic Surgery Associates team includes Dr. Franklin Richards, Dr. A. Dean Jabs, and Dr. Keshav Magge. Each of our plastic surgeons is board-certified, and together they have over 60 years of combined experience. Drs. Richards, Jabs, and Magge are all highly qualified in procedures for the face, breast, and body, and pride themselves in providing excellent results through our state-of-the-art, Quad A certified operating centers