Armpit or Under-Breast Incision for Breast Augmentation?

Short answer: In Korea the armpit (액와) incision is still described as the most common, because the scar hides in the armpit fold and nothing marks the breast. The under-breast fold (밑선) incision gives the surgeon a direct view, usually hurts less afterward, and is easier to reuse for a revision, but the scar sits on the breast itself. Expect a recommendation tied to your tissue and implant size, not a menu.

Most patients from North America ask about scars first. Korean surgeons tend to answer with anatomy.

Why is the armpit incision so common in Korea?

Because many Korean patients don't want any mark on the breast. Banobagi Plastic Surgery's Lee Yu-jeong described the armpit approach as the most common in Korea in a clinic article, with the fold incision gaining ground.

It's often done with an endoscope (내시경), a camera passed through the cut so the surgeon can see the pocket. Ask whether yours is. With your arms down, the scar doesn't show.

What's the downside of going through the armpit?

Distance. The cut is several inches from where the implant sits, so the surgeon dissects a longer tunnel, bleeding is harder to control, and the armpit itself is sore afterward. Choi Byung-hoon of Yonsei Image Line Clinic told Healtho that patients often can't use their arms normally for several days.

One Korean patient on Sungyesa wrote that by one month the armpit pulling had eased enough to raise both arms overhead.

The Aesthetic Society, a US surgeons' group, says the armpit route takes more tissue handling and carries extra risk of numbness or changes in muscle function.

What does the under-breast incision give you instead?

Control. The surgeon works right at the fold, which makes it easier to set the height of the new crease and shape the lower breast precisely, according to the Banobagi article. Bleeding is easier to manage, and the clinic describes less pain.

The cost is a scar in the fold, which a small breast doesn't always cover. Banobagi suggests the fold incision for women who already have some volume, mild sagging that hides the crease, or changes after pregnancy, and the armpit for younger, slim patients.

Does the incision change how long you stay in Seoul?

Sometimes, by a few days. Some Korean clinics close an armpit incision with skin glue, which leaves no stitches to remove. A fold incision usually has stitches out around day 7 to 10.

That can move your flight from day 7 to day 10. See how soon you can fly after breast augmentation.

Why does the incision matter for a future revision?

Implants aren't permanent, and the next operation may need a direct view. If you later need capsule removal or en bloc removal, surgeons generally prefer to work through the fold. An armpit scar from the first surgery doesn't stop that, but you'd end up with two scars.

Ask: "If I need this taken out in 10 years, where would you cut?" See replacing implants after 10 years.

What about the areola incision?

It's offered, less often. The cut runs along the lower edge of the areola, so a small areola limits implant size. It also passes through milk ducts, and a 2017 meta-analysis found higher capsular contracture with the areola route than with the armpit or fold.

How we help with the decision

• Free, itemized quotes from 2–3 specialist clinics, with the incision each surgeon proposes and why.
• An interpreter in the consultation room so you can ask the revision question in plain words and hear the answer directly.
• Scheduling around your incision, so a fold incision's stitch removal is already in the plan, plus airport pickup. No charge to you.

Ask for free quotes from the form below.

Frequently asked questions

Which breast augmentation incision is most common in Korea?

The armpit incision, according to Korean clinics, because the scar is hidden in the armpit fold. More patients are now choosing the under-breast fold.

Is the armpit incision more painful?

It tends to be. The implant travels farther from the cut, and Korean surgeons say patients often have armpit soreness and limited arm movement for several days.

Does an armpit incision need stitch removal?

Not always. Some Korean clinics close it with skin glue. Under-breast incisions usually have stitches removed around day 7 to 10.

Which incision is better for a future revision?

Surgeons generally prefer the under-breast fold for capsule work and en bloc removal, because it gives a direct view. An earlier armpit incision means a second scar.

Is the areola incision used in Korea?

Yes, less often. It limits implant size when the areola is small, and a 2017 meta-analysis linked it to higher capsular contracture than the other two routes.