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 procedures, we at Cosmetic Surgery Associates know what works best for our patients.
Periareolar
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.
Inframammary
This incision is made under the breast in its natural crease. There are advantages to 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 ensure this 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.
Our Special Pain Reducing Technique
We’ve developed a special technique at Cosmetic Surgery Associates that dramatically reduces pain after breast augmentation and shortens 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.
Keshav Magge, MD, FACS
Board-Certified Plastic Surgeon
Honored as a Top Doctor by Bethesda Magazine and Washingtonian in both 2024 and 2025, Dr. Magge is recognized for his exceptional surgical skill, artistic precision, and patient-centered approach. A leading plastic surgeon in Bethesda, Maryland, he completed a fellowship in Craniofacial and Pediatric Plastic Surgery at Children’s National Medical Center in Washington, D.C., where he gained advanced expertise in facial rejuvenation and aesthetic surgery innovations.
Meet Dr. Magge
A. Dean Jabs, MD, PhD, FACS
Board-Certified Plastic Surgeon
Dr. Jabs is an award-winning, board-certified plastic surgeon recognized nationally for his expertise in creating natural-looking results and his warm, compassionate approach to patient care. Trained in NY at Columbia University, he served in the US Army and has special expertise in facial rejuvenation. He has over 35 years of experience and has consistently been voted a top plastic surgeon by Washingtonian and Bethesda magazine.
Meet Dr. Jabs
Franklin D. Richards, MD, FACS
Board-Certified Plastic Surgeon
Dr. Richards has been recognized as a Top Doctor by several prestigious organizations, including Castle Connolly, Consumers’ Research Council of America, and Washingtonian magazine. A leading plastic surgeon in Bethesda, Maryland, Dr. Richards is the past Chief of Plastic Surgery at Johns Hopkins Suburban Hospital. His expertise is in achieving natural results in facelift and eyelid surgery, with additional interests in cosmetic surgery of the breast and abdomen.
Meet Dr. RichardsPatient Photos
View our gallery to see photographs of real patient results at Cosmetic Surgery Associates.
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Patient education is one of our primary goals. Check out our educational video series to learn more about specific procedures and view real results.
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