Slow Implant Settling Process for Transaxillary Approach?

I had silicone implants placed submuscular via the transaxillary approach. The disadvantage is that it will not give my PS dual plane access or the ability to do the dual plane (according to him), and it will tend to ride higher and settle slower than through the inframmary approach. Would this mean that I am at a disadvantage of having less natural results because I have full submuscular vs dual plane? I am one week post op, was a preop 32A, and my muscles are holding the implants high close to my collarbone.

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4 Doctor Answers | Asked by stomachsleeper in palo alto, ca

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Transaxillary problems with implants

The transaxillary approach is one option for the incision. One of the problems can be inadequate release of the muscle inferiorly leading to high implants. Give it some time, they may come down.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Breast implants do settle

Smooth shelled breast implants definitely "settle". Submuscular breast implants almost always appear too high and tight in the early post-operative period. They almost always get lower as the muscle relaxes. This occurs regardless of the location of the incision. In my experience, the larger the implant, the more they tend to settle. Textured shelled implants are different. They settle much less.

Unfortunately, I don't think they will come down.

Hello again, stomachsleeper! We are all prone to wishful thinking, even plastic surgeons. So this notion has developed that implants will somehow "settle". I have done many hundreds of breast augmentations, and that is not my experience. Breasts need to look great and implants need to sit at the right level immediately after surgery. Otherwise, they probably will not later. What I recommend is sitting the patient up before the end of the operation (you are still asleep, of... more

Not a question of dual plane...

All subpectoral muscle implants are dual plane as opposed to completely submuscular since the pectoralis muscle is triangular in shape and normally does not mirror the surface area of the breast tissue. The problem with the transaxillary apporach is that if the dissection is done in a usual blind and blunt manner the inferior release of the fascia and muscle may not be accurate nor complete as necessary to create an adequate pocket. The inability to release the muscle will cause the muscle... more