If a primary breast augmentation is done through the armpit, can a second surgery to increase size be done through the same incision site of the armpit?
Can You Use the Same Incision to Increase Breast Size?
Doctor Answers (15)
It can be done through transaxillary incision
There is no question that the transaxillary incision can be used to exchange implants. That has been my prefered method for the 20 years that I have been in practice. In those years, 74% of my revisions have been able to be done through the transaxillary approach the second time.
I agree with other physicians who have answered this question, as there are some other things to think about, such as how big you would like to go, and how big the pocket is currently. It is almost impossible to do a capsulectomy (removal of the entire capsule, which is scar around the implant) through the armpit, but you can do a capsulotomy through the armpit fairly easily (cutting through the scar to make the pocket bigger).
I have put in large implants through this incision (700 to 800), so I do disagree with saying that there is a "maximum" size that can be placed through the armpit. One of the biggest factors is how comfortable your surgeon is with that approach. The more familliar, the less trouble he or she will have using that incision for revisions.
Make sure that you find a Board Certified Plastic Surgeon to take care of you, and preferably one that is a member of the American Society for Aesthetic Plastic Surgery, as these surgeons do most of their work in Aesthetic surgery. Good luck with your search, and having a successful surgery and recovery.
Breast Implant exchange
Certainly the same incision can be used to replace implants provided that there is no significant capsule or other problems with the pocket. It is very hard to correct problems from a transaxillary approach.
Don't recommend putting in larger breast implants through armpit.
For larger breast implants, your surgeon needs to make larger pockets in your breasts. This can be a fair amount of surgery and difficult to do through the armpit. I think you would decrease your chances of having great shape and symmetry.
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Same incision can sometimes be used to increase breast size
Doing much capsule work (like a capsulotomy) through the arm pit incision can be difficult. This is one of the reason many docs are not-so-crazy about the "through the arm pit" approach.
So the answer is it depends upon what surgery needs to be done through the arm pit that second time around. If it is simple, maybe it could be done.
In general, you can use the same incision
If it is just a simple exchange to increase the size of your implants, yes, the transaxillary incision is fine. If you need a complex capsulectomy performed at the same time, your surgeon might suggest a different incision. Depending on how much "work" needs to be done to the pocket around the implant, more direct incisional approaches might give your surgeon better access / exposure, and you might end up with a better result.
You should visit with a board certified plastic surgeon and discuss your goals, listen to their suggestion and reasons for their preference. Good luck!
Most likely you can use the same incision.
It all really depends on your specific situation and the skill of your surgeon. However, in most cases, the surgery can be done through the same incision without a problem. Good luck.
Still possible to use the axillary approach
It is still possible to use the axillary approach. This will be a more likely situation if you have saline implants and are planning on staying with saline implants. I prefer to use an endoscope for my transaxillary breast augmentations.
However, I do not prefer to place silicone implants via the axillary approach. Most often, I will use the periareolar or inframammary approach for primary and secondary cases. Having said this, you should not fear the periareolar approach to your surgery as the scars, many times, heal beautifully.
Secondary augmentation through same incision possible
A secondary procedure through the same incision in the armpit can certainly be done. The implant, however, usually cannot be saved and must be replaced with a new one. I would find a Plastic Surgeon who is very familiar with the procedure. Recovery after a secondary procedure is minimal.
Using same incision depends on your goal
I think whether it is advisable to use this incision really depends on what your ultimate goal is. A minor increase in size that involves the addition of fluid to an existing saline implant should be possible. Placement of a larger implant (particularly if silicone is your preference, with adjustment of the breast shape), would not.
I would review your goals for volume increase with your surgeon. Only after a good exam and review of your goals will he/she be able to say whether your goals are attainable through the existing scar, or whether another incision is advisable.
I think it bears emphasizing that using the existing scar is only something worth doing if it will give you what you want.
It might be possible
Revisionary surgeries are more difficult from the more remote incisions but can sometimes be done especially if the pockets don't need too much work before replacing the implants. So, the answer is that it depends on your anatomy, your surgeon, and what kind and size of implant you are placing.
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