Just Two Centimeters Away!

With refined techniques of breast augmentation and the ever improving breast implants, can you imagine that, with a 2cm incision (almost same incision length as that in double eyelid surgery), we will be able to insert a breast implant of several hundred cubic centimeters (cc) for you? 

Minimally invasive breast augmentation surgery has been the goal of Director Chuang Chia-Jung, M.D., who has been constantly researching to prevent the distress of his patients that surgical scars may bring them and to effectively reduce the post-surgical recovery time. In order to fulfill his self-pursuit of a true minimally invasive surgery, Dr. Chuang not only refines every procedure in breast augmentation, develops innovative techniques for inserting breast implant and for wounds closing, he also adopts the newly high-end Motiva breast implant. Finally, Dr. Chuang has achieved the unbelievable mission and his ultimate goal of using 2cm incision for all kinds of breast implants. This may be the minimum incision length in breast augmentation surgery and a perfect display of modern breast augmentation!

What is 2cm breast augmentation?

The so-called 2cm breast augmentation, as the name suggests, is making a nearly 2cm incision to complete the entire surgery, including surgical dissection to create internal space and safe delivery of breast implant. In order to achieve this seemingly impossible task, Dr. Chuang must have full concentration and apply the best surgical instruments and endoscopic headlight to perform internal pocket dissection and stop bleeding at the surgical plane. Lastly, Dr. Chuang applies his unique techniques to insert the breast implant and suture the wound, thus completes the surgery through closely intertwined procedures in order to present the best result.

2cm incision of IMF in breast augmentation – Silicone gel implant

2cm incision of IMF in breast augmentation – Motiva implant

2cm incision of IMF in breast reconstruction – Silicone gel implant

2cm incision for silicone gel breast implant

2cm incision for Motiva breast impant

Where is the 2cm incision located?

Inframammary fold (under breast line) incision has the advantages of safety, pain free, and fast recovery, so it is certainly the first choice for the minimally invasive breast augmentation. Especially the internal fixation sutures of inframammary fold can be performed simultaneously with the wound closing to embed the incision deeply in the shadow of new inframammary fold so that the lower pore of breast can have natural “smiling line” like the real breast soon after surgery. In doing this, we can not only sculpt the breast into tear-drop shape by using round breast implant, but also make sure that the result can be stable for a long period of time without any complications like breast deformation, unsymmetrical breasts, double-bubble deformity, or even dislocation/sliding of the implants.

What are the features of 2cm incision?

Since the inframammary fold is part of the skin folding of breasts, incisions there endure less tension than those in axillary region, which moves more often. Thus, the 2cm incisions made by Dr. Chuang doesn’t need any skin sutures. Instead, the wound will be sealed by advanced topical skin adhesive so that the incision is not only water-proof but also free of suture removal. The patient can even take shower without extra protection on day 4 post-surgery and remove the skin adhesive 12-14 days after surgery to complete the entire post-operative process and begin nursing care of the scars. This revolutionary maneuver not only improves patients’ lift quality  immensely but also leaves them a fine line scar eventually which is not like the railway track type of scar by traditional suturing!

Comparison between inframammary fold and axillary incisions

Inframammary fold incision Axillary incision
Incision length 2-2.5 cm (minimally invasive surgery) 3-5 cm
Incision location In the shadow of inframammary fold In the folds of axillary skin
Ways of suture Three layers of internal suture + tissue adhesive for closure Single layer of internal suture + skin suture
Wound dressing No need Must be changed every day
Suture removal No need (stitch free) Must
Water proofing Can be touched by water with no extra covering on day 4 after surgery Can contact with water on day 7 after surgery only when the stitches are removed
Painful sensation Very low Relatively high
Subsidence of swelling Fast Slow
Limitation of exercise 1 month 2-3 months
Rehabilitation after surgery No need Need to do hand raising and arm stretching
Nipple sensation loss Lower than 10% ~20-30%
Scar recovery time Over 1 year 1 year
Scar pattern Linear type of scar Railway track type of scar
Scar adhesion None Possible

Where is the breast implant placed in 2cm breast augmentation?

Current mainstream of breast augmentation emphasizes both size and natural look of the breast; so the smoothness of the upper half of breast and the central cleavage determine how superiority the surgery is. Due to this concern, Dr. Chuang usually suggests using a dual- plane dissection method (half muscle – half fascia, or so called sandwich-type of breast augmentation) to patients who are undertaking large breast implants in 2cm minimally invasive breast augmentation. This method can reserve 2/3 of chest muscle (pectoralis major) that sits above the upper breast to cover the breast implant and the lower 1/3 of chest muscle can be partially divided for the implant to be half-exposed underneath the breast tissue or fascia. This can shorten the time for the breast to manifest itself in the tear-drop or peach shape, and effectively prevent the elevation or high ridding movement of implant due to contraction of the pectoral major muscle, or unnatural sense of bouncing of the implant when the patient flexes arms (animation). This should be the most proper solution of breast augmentation for oriental women.  

For those who have thick skin, tubular breasts or sagging breasts, Dr. Chuang may also suggest subfascial breast augmentation. This surgery can also be done through 2cm incision at the inframammary line.


Is Motiva breast implant the only choice of prosthesis in 2cm breast augmentation?

The key factor that determines the length of incision is the expertise of doctors but not the choice of implants. To be exact, if the doctor can perform complete internal space dissection through such a small incision, he/she should have no problem inserting the implant. Due to the fact that Motiva breast implant has higher elasticity and stretch-ability, the process of its implantation should be smoother and safer. Relatively speaking, it can also reduce the tension and trauma at the incision edges and benefit the healing of wound and recovery of scar.  

No matter what the patient chooses, the modern Motiva breast implant or traditional smooth/textured surface silicone gel breast implant, Dr. Chuang will always try his best to minimize the incision according to the characteristics of patient’s skin. This is our true potential at display in performing the minimally invasive breast augmentation.

Is there any risk in delivering breast implant through a 2cm incision?

The safety of surgery is Dr. Chuang’s top concern in performing breast implant. He will perform the 2cm breast augmentation only when he is confident in keeping the breast implant intact and not be deformed during the process of implantation. In order to safely insert the breast implant, Dr. Chuang not only innovates the incision design, but also develops his special hand skills in delivering the breast implant through the incision. In most conditions he can safely deliver the large breast implant through such a small incision within 30 seconds. This prevents the possibility of implant deformation, gel fracture or even damage of its outer surface during the process of pushing through the small incision, and ensures the long-term durability of implant to be the same as in traditional breast augmentation! All of this is supported by cumulated experience of Dr. Chuang who has performed thousands of cases in breast plastic surgery. 

Although the 2cm incision is sufficient for safe insertion of Motiva or silicone-gel implants, the incision will undergo substantial tension during operation to make the wound healing slower. It usually requires 10-14 days for the wound to heal completely, and the patient needs to take good care of the wound after the tissue adhesive has been removed. Try to avoid sweat stained or external friction from affecting the wound to prevent slow wound healing, which may cause hypertrophic scars or pigmentation and defeat the perfect result of minimally invasive breast augmentation surgery!

Is 2cm incision applied in breast implants of any sizes?

The answer is not definitely yes. In order to achieve the minimally invasive breast augmentation with a 2cm approach, it requires not only Dr. Chuang’s innovative surgical technique, but also depends on the patient’s qualification and needs, such as the thickness and elasticity of soft tissue and skin tension, as well as patient’s expectation of the size enlargement. Usually Dr. Chuang will have preliminary evaluation based on patients’ personal condition during consultation, and make his final decision in incision length while performing the surgery. The priority is minimizing the incision on the premise that it is safe to proceed. In addition, we have a general reference standard between the implant size and the incision length. There will be no major difference in incision length between choosing Motiva breast implant or silicone gel implant.

Is the scar also 2cm in 2cm breast augmentation?

It is not necessarily so! There are multiple factors to influence scar formation, such as the severity of breast swelling after surgery, the period of recovery, the healing process of wound, the tightness of skin tension, personal skin quality, with or without scar tendency, or even the method or period of scar caring. Many of these factors cannot be fully predicted or controlled in the operation. If you expect that the final scar will be as short or inconspicuous as the incision, minimizing the incision in the most important step to make it. In addition, taking good care of the scar with patience for at least 6 months under the guidance of Dr. Chuang or our nurses is also important. We believe that most patients can achieve satisfactory results if they can take our advice during the whole recovery period.

Reference between the incision length and the implant size in minimally invasive breast augmentation

Size of implant Length of incision
<300 cc 2cm
300-400cc 2-2.5cm
400-500cc 2.5cm
>500 cc 3cm

Who is not a good candidate to receive 2cm Breast Augmentation?

In general, there is no special contraindication for 2cm breast augmentation. The operation is suitable for most patients who are willing to place incision at the inframammary fold (under breast line) for breast augmentation. In addition, the 2cm method has nearly no relevance to the type or size of implant. However, patients with unique characteristics, including those who were previously confirmed with keloid tendency, those who excessively care about the perception of  breast augmentation by their partners, or even those who go for small-sized breast implants that are not big enough to cover up the under breast scar, should consider more seriously on whether they can accept an incision in the inframammary fold. Regardless of the location of incision, on average, it takes around 1-2 years for the scar to be faded on Middle East or Asian’s skin type. For patients who exceedingly except for complete scar disappearance or hidden scar in recovery period, they should consider an incision located at place where the limb will cover up such as armpit. Therefore the process of scar healing or other uncertainties would not affect the expectations and happiness of breast augmentation!

Indications of 2cm breast augmentation

Indication Contraindication
Fear of pain Confirmed with scarring physique such as keloid
Those with work that would require rapid recovery of arm movement for lifting, or athletes Dark skinned or with easy pigmentation
Huge breast implant which would require strong support from the inframammary fold Small-sized breast augmentation wich is

insufficient to cover up the wound in the under breast shadow

Breast implants large enough to cover up the incisions in the inframammary fold Overly worried about scar healing or slow recovery
Using breast implants to correct the sagging breasts Worried about the partner to notice the scar when lying down
Often wearing sleeveless dresses or those who need to expose their underarms frequently
With excessive underarm sweating or pigmentation
Previously underwent breast augmentation or apocrine sweat gland surgery from the axillary area

Is 2cm incision applicable for revision breast augmentation?

2cm breast augmentation is available for primary or secondary patients. However, revision breast augmentation is very complicated due to various problems and symptoms individually, so Dr. Chuang would have to evaluate each patient’s condition in person before advising the proper incision and procedure. Clinically, a 2-2.5cm incision is sufficient for the safe removal of total capsule in mild to moderate capsular contracture case and for the implant replacement. In cases with serious capsular contracture or severe breast deformity and asymmetry, we would often be able to complete the whole revision breast augmentation with a 2.5-3cm inframammary fold incision. Therefore, it seems no big difference between the incision length of a revision breast augmentation and a primary case. The key part of 2cm revision breast augmentation is to completely recognize and fix the breasts’ internal problems to obtain a natural and stable result!

If you have any questions related to minimally invasive breast augmentation, please contact our chief consultant Ms. Huang at any time.

Telephone line (24-hour transfer):+886 2 27762360

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