Incisions in the arm pit are sometimes used to put the implant under the muscle. This is a direct route to the pocket but has the disadvantage that the incision is always visible when the arms are raised. An incision around the nipple may not be appropriate in women who may want to breast feed in the future. An incision on the undersurface of the breast is always concealed by clothing and provides a direct access to the pocket. If placed too high it may become thick and if placed too low it will show if the arms are raised and a bikini or bra rides up.
Some surgeons use an incision in the navel and burrow up under the skin into the breast area.
This is called an endoscopic approach. It is suitable for some patients but is not widely used. The pocket is made a little larger than the implant. The pocket for smooth implants is usually made significantly larger than for a textured implant. After the pocket is made the surgeon checks for bleeding and often washes out the pocket with an antibiotic to reduce the risk of infection .