Every breast augmentation leaves a scar, but we can now keep it very short and place it in a discreet fold. In our practice, classic augmentation usually involves an incision of about 3 cm in the breast crease; Preservé uses 2.4–2.5 cm, also beneath the breast; and mia uses approximately 2.3 cm in the armpit, with no scar on the breast itself.
Where is the scar after breast augmentation?
It depends on the technique and your anatomy. The most common approach for classic augmentation is the inframammary crease, because it gives direct control of the pocket and hides the scar beneath the breast when there is a sufficient fold. Tissue-preserving techniques have reduced the incision further: Preservé keeps the incision in the crease, while mia moves it to the armpit.
An incision along the lower half or the full circumference of the areola remains useful for specific indications, particularly for tuberous breasts or when we need to change the shape, position, or size of the areola. We do not perform transumbilical breast augmentation (TUBA).
In this article
Breast crease, armpit, or areola: comparing scars
The shortest scar is not automatically the best. Its location also matters, along with the control it gives the surgeon, the implant size and type, the breast shape, and whether we need to correct an issue involving the gland or areola.
| Approach | Location and usual length | When we use it | Expected visibility |
|---|---|---|---|
| Classic minimal-scar augmentation | Inframammary crease, averaging about 3 cm | Conventional augmentation; a larger incision may be needed for a very large implant | Usually hidden beneath the fold |
| Preservé | Inframammary crease, approximately 2.4–2.5 cm | Minimally invasive prepectoral augmentation in selected patients | Very discreet if the breast already has a small fold |
| mia | Armpit fold, around 2.3 cm | Subtle-volume prepectoral augmentation within its indications | No scar on the breast itself; the armpit scar is usually visible only when the arm is fully raised |
| Hemiareolar or periareolar | Lower border or circumference of the areola; variable length | Tuberous breasts or a need to lift, reduce, or reshape the areola | May blend into the color transition, but is not our routine approach for straightforward augmentation |
Why do we not choose the incision by length alone?
The incision must allow the implant to pass through without placing unnecessary tension on its edges or the skin, and provide enough access to create the pocket precisely. Forcing an excessively small opening can cause more tissue trauma. The lengths given here reflect our practice, not a millimeter-by-millimeter promise for every implant.
Minimal-scar augmentation through the crease: our classic technique
For classic breast augmentation, we usually make a short incision in the inframammary crease. Its average length is around 3 cm, unless the implant size or characteristics require a longer opening. Direct access provides precise visibility and control of the pocket.
We plan the scar so the new breast will cover it as it settles. If the starting breast is very small and has no fold, the scar may be visible from below or when the breast is lifted during the first few months. As it matures, it usually becomes paler and much less noticeable.
In our experience, its final visibility is usually minimal and satisfaction is very high. Nevertheless, no technique can guarantee how an individual will heal: skin biology, tension, smoking, infection, or wound separation can affect the outcome.
What scars do mia and Preservé leave?
Both are implant procedures and both leave an incision. Their defining difference is not simply a small opening: they use specific approaches and instruments to create the prepectoral pocket in a controlled way and preserve tissue as much as possible in appropriately selected patients.
mia®: away from the breast
We place the incision near the edge of the pectoral muscle, within the armpit fold. It is usually hidden with the arm in its natural position; seeing it normally requires deliberately raising the arm and exposing the armpit.
This is an important advantage if you want to avoid any scar on the breast itself. In return, mia has a more limited volume range and requires anatomy that fits a very specific protocol.
Preservé™: small and beneath the breast
Preservé inserts the implant through a short incision in the crease. It offers more volume and anatomical options than mia while maintaining a minimally invasive, prepectoral approach.
If there is already a fold, the scar is well concealed. On a completely flat breast, it may initially be somewhat visible from below, until the breast settles and the scar matures.
A prospective mia study in 100 patients used the armpit approach and assessed safety, satisfaction, and scar quality over three years.3 A recent systematic review of transaxillary augmentation found high satisfaction and complication rates comparable to other approaches, although the available evidence remains heterogeneous.4
An areolar scar: when it makes sense
A lower hemiareolar approach follows part of the lower areolar border. A full periareolar incision goes around its entire circumference. The transition between pigmented areolar skin and breast skin can help conceal the line, but this does not make the approach the best choice for every augmentation.
Tuberous breasts
It may be necessary to treat an enlarged, protruding, or misshapen areola and reshape the gland.
Reducing or reshaping the areola
The incision allows direct treatment of an areola that is too large or has a shape we want to correct.
Lifting the areola
In selected cases, it can be combined with repositioning, while recognizing the limitations of a periareolar lift.
We do not routinely choose an areolar approach simply to avoid a small crease scar. Working through or close to the gland, tension at the areolar border, and the risk of scar widening must be considered. A meta-analysis found more capsular contracture with periareolar than inframammary incisions, although the authors called for higher-quality comparative studies with longer follow-up.2
Is scar-free breast augmentation possible?
An access incision is needed to insert an implant. What we can do is reduce its length when the technique and implant allow, choose a discreet location, close it carefully, and actively support scar maturation.
“No scar on the breast” can accurately describe mia because the incision is in the armpit, but it does not mean “no scar.” Likewise, a well-hidden inframammary scar still exists even if it is difficult to see in clothes, a bikini, or a normal position.
The AEMPS explains that scars are an inevitable result of surgery and that individual scar quality cannot be guaranteed, even with meticulous suturing.1
An augmentation scar is not the same as a breast-lift scar
Straightforward augmentation only needs an opening to create the pocket and insert the implant. If there is true sagging and we need to remove skin or substantially lift the areola, the procedure is a mastopexy: it may require a scar around the areola, a vertical scar, and often a horizontal section along the crease.
Promising an augmentation-sized scar to someone who needs a lift can lead to a poorer shape or recurrent sagging. For some mild or moderate cases, indications are expanding with Preservé mastopexy, but anatomy and the amount of excess skin still determine what correction is reasonable.
How a breast augmentation scar evolves
A photo taken in the first few weeks cannot predict the final result. Swelling, color, and firmness change at different rates. As a general guide, this is the usual course when the wound closes without complications:
Closure and swelling
The line may be red, slightly raised, and surrounded by swelling. Keep it clean and protected according to your wound-care instructions, avoiding effort or movements that pull unnecessarily on the closure. Do not apply cosmetics or sunscreen to an open wound.
It may look more noticeable, not less
Some scars become redder during the proliferative phase and look more prominent before starting to fade. Mild itching or tightness can occur, but increasing pain, discharge, or wound separation is not normal progress.
Active remodeling
The tissue starts to soften and the color usually fades. This is an important time to continue silicone dressings and sun protection according to your individual protocol.
Flattening and fading
Most scars become finer and paler. They may still be red or pigmented, particularly in skin more prone to hyperpigmentation.
Final maturation
The result can be assessed more reliably at one year, but some scars continue changing until 18 months. A mature scar does not disappear: it becomes flat and closer in color to the surrounding skin.
What we do to support the best possible scar healing
A short incision helps, but the outcome does not depend on centimeters alone. Planning, closure, tension, follow-up, and each patient's biological response are all part of the same process.
Planning and closure
We position the incision in the planned fold and avoid forcing an opening smaller than safe implant insertion allows. Meticulous closure aims to align the edges and reduce tension.
UrgoTouch-type laser or equivalent
After closing the incision, we apply an intraoperative scar-healing laser such as UrgoTouch or an equivalent technology. This is a single application in the operating room and an important part of our protocol.
A randomized, double-blind trial in breast reduction found objective improvements in scar volume, surface area, and roughness at one year in the segment treated with a 1210 nm laser, along with greater patient preference.5 This is direct evidence about breast-surgery scars, but not specifically straightforward augmentation, and it cannot guarantee an individual result.
Silicone for 3–6 months
Once the wound is completely closed, we recommend silicone dressings for at least three months and ideally six months. Askina Scar Repair is usually our first choice for its gentler adhesion; Trofolastin, a polyurethane dressing, is an alternative with stronger adhesion when a particularly secure dressing is desirable.
International recommendations place silicone products among the first noninvasive options for preventing and treating scars, although the size of the benefit and quality of the evidence vary between studies.67
Sun protection: at least 12 months
Once the wound has closed, we protect the scar with broad-spectrum SPF 50+, shade, and an appropriate physical barrier for at least 12 months and until it is completely pale. Some patients need 18 months.
Early postoperative laser treatment
If persistent redness, thickening, or other abnormal changes develop, we may add early laser treatment tailored to the color, contour, healing stage, and skin type. Pooled evidence supports early treatment of selected surgical scars, but the device and schedule are not the same for everyone.8
Laser does not replace scar care or erase a scar
We use it to try to improve healing after proper wound closure and act early if an unfavorable response develops. It cannot eliminate genetic variation, tension, smoking effects, infection, or other factors that can affect healing.
When to contact the team
The wound opens or drains
Separated edges, persistent moisture, pus, an unpleasant smell, or bleeding require assessment and should not be covered with cosmetics.
Pain and redness increase
Especially with warmth, fever, feeling unwell, or a sudden change from previous days.
The scar becomes raised, hard, or grows
This may be a hypertrophic scar or, less often, a keloid. Early treatment offers more options than waiting without a review.
The scar widens or becomes depressed
Tension, previous wound separation, or the quality of the dermis can leave an atrophic, depressed, or progressively wider line.
An adhesive reaction
Severe itching, eczema, blisters, or small skin erosions mean the dressing needs to be removed or changed as directed.
Progressive darkening
A scar that becomes pigmented after sun exposure needs stronger protection and an early assessment of whether treatment is appropriate.
Compare augmentation results in patients with anatomy similar to yours
Our gallery lets you filter cases by height, weight, volume, shape, and technique. Photos help you assess overall breast proportions; at your consultation, we also show comparable examples of scar location and healing.
Interactive gallery
View breast augmentation before and after
Filter and open each complete case
Questions about breast augmentation scars
What is the best scar location for breast augmentation?
No location is best for everyone. In our practice, the crease is the usual approach for classic augmentation and Preservé; mia uses the armpit. We mainly reserve the areolar approach for tuberous breasts or when we need to treat the areola itself.
How long is a breast augmentation scar?
As a guide to our practice: around 3 cm for classic minimal-scar augmentation, 2.4–2.5 cm with Preservé, and approximately 2.3 cm with mia. A very large implant or particular anatomy may require a longer incision.
Will a crease scar show in a bikini?
It is normally covered by the breast itself and the bikini. If the starting breast is completely flat with no fold, it may be somewhat visible from below during the first few months. We plan its position so the new crease conceals it as the breast settles.
Does mia really leave no scar on the breast?
Correct: mia's scar is in the armpit, not on the breast. However, there is still an incision of approximately 2.3 cm, and it needs care just like any other surgical wound.
When does the scar stop being red?
There is no identical timeline for everyone. It may be pink or red for several months and continue fading until 12–18 months. If the color intensifies or the scar becomes raised, very itchy, or painful, arrange a review.
Does the scar disappear completely?
No. A well-healed mature scar may become a fine, flat, pale line that is hard to locate, but scar tissue does not become intact skin again, and complete disappearance cannot be promised.
How long should scar dressings be used?
In our protocol, once the wound is fully closed, we continue silicone dressings for at least three months and ideally six months. The product and schedule may change if the skin becomes irritated or healing takes a different course.
What does intraoperative UrgoTouch laser do?
It is a scar-healing laser we apply in the operating room immediately after closure, in a single session, to encourage more favorable scar healing. There is evidence in breast surgery, particularly reduction, but it does not erase the scar or guarantee how each patient will heal.
What if I am prone to keloids?
Discuss this before surgery and show us previous scars. A personal history changes monitoring and preventive planning. If the scar starts growing beyond its edges, becoming hard, or itching severely, it needs an early assessment.
Can a poorly healed scar be corrected?
It can often be improved, but treatment depends on whether it is red, raised, wide, depressed, or pigmented, and how long it has been present. Options may include silicone, laser, injections, or surgical revision in selected cases. Revision leaves a new incision and may require additional scars if a broader breast correction is needed. There is no single solution for everyone.
Guidelines and studies used
- AEMPS: patient information about breast implants, updated July 20, 2026.
- Li et al.: capsular contracture with periareolar versus inframammary or transaxillary incisions, a meta-analysis.
- Three-year prospective study of mia Femtech in 100 patients.
- Systematic review and meta-analysis of transaxillary breast augmentation in 11,686 breasts.
- Casanova et al.: randomized trial of intraoperative 1210 nm laser treatment of breast scars.
- Wang et al.: systematic review and meta-analysis of silicone gel for scar management.
- Updated practical recommendations for scar management and silicone use.
- Wang et al.: safety and efficacy of laser or intense pulsed light for early surgical scars, a systematic review and meta-analysis.
The best scar goes with a properly indicated technique
Classic augmentation may leave a line of about 3 cm, almost hidden in the crease. Preservé reduces the opening to approximately 2.4–2.5 cm, while mia moves an incision of around 2.3 cm to the armpit. The choice should not depend on a few millimeters alone, but on the result, volume, coverage, and anatomy.
We then treat scar healing as a process lasting more than a year: intraoperative laser, silicone for three to six months, strict sun protection, and early action if healing departs from expectations.
Medical authorship Specialist in Plastic, Aesthetic and Reconstructive Surgery (Spanish MIR training) Medical registration no. 2828/61062 · Madrid About Breast Augmentation Scars: Location and How They Heal: clinical information, safety and expectations. Based on the original Spanish content. Translation does not constitute a new medical review. This information does not replace an individual medical assessment. References support the general medical information. Suitability, alternatives, and risks are discussed individually during consultation.
Medical sources and editorial standards
Selected references for this article
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