Can Larger Implants Be Used in Revision Surgery Through Transaxillary Insertion

I had my breast augmentation 9 months ago and chose round, 375 cc high profile silicone implants under the muscle. I am now wanting to go a fair bit larger -roughly 500 - 650 cc as I still feel too small with the 375cc and am now considering a revision surgery. As I had the original implants inserted in the arm pit to avoid scarring on my breasts, can i use this insertion area in a revision if I go larger, and are there limits to size for the transaxillary insertion?

Doctor Answers (7)

Transaxillary incision and larger implants

+1

You do have a good bit of asymmetry now and it would be nice to know if this was also there  before augmentation. Over all, I use the axillary incision and an endoscope for most primary augmentations and simple size increases. For more complicated procedures another incision is the way to go as explained so well by Dr, Finger. Good Luck!


Richmond Plastic Surgeon
5.0 out of 5 stars 24 reviews

Breast Implant Exchange Through Axilla?

+1

Thank you for the question.

In my hands, the type of revisionary surgery that you are contemplating is best done through a incision on the breasts. This incision allows me to adjust the breast implant pocket under direct vision.

If your surgeon has significant demonstrable experience with the type of surgery that you are contemplating then you should feel comfortable proceeding.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 703 reviews

Implant exchange through transaxillary incision

+1

Can the implants be removed and reinserted through the axillary incision?  The short answer is yes. The more complete answer is the incision would have to be much longer and would be more visible than any virtually other incision. If you have a tight pocket, it would have to be enlarged, and that is very difficult because the scar capsule would have to be removed through the axilla. In my opinion, after having done several thousand transaxillary implants, is that it is a bad idea and very risky. In addition, you may like the very large implants at a young age, but as you grow older, they will sag and may cause chronic pain in your neck and shoulders. Many women want smaller implants as they age. Keep this in mind, and think of the downsides and risks.  They are real, and they do happen.  Good luck. 

E. Ronald Finger, M.D.

E. Ronald Finger, MD
Savannah Plastic Surgeon
5.0 out of 5 stars 33 reviews

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Breast implant revision through armpit

+1

Goign through the armpit for a revisoin may be problematic especialy if there is a tight capsule that needs to be released or even removed.  Plus with a larger silicone implants, the incision may have to be lengthened.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 16 reviews

"Going Bigger" through Arm pit Incisions

+1

Regarding : "had my breast augmentation 9 months ago and chose round, 375 cc high profile silicone implants under the muscle. I am now wanting to go a fair bit larger -roughly 500 - 650 cc as I still feel too small with the 375cc and am now considering a revision surgery. As I had the original implants inserted in the arm pit to avoid scarring on my breasts, can i use this insertion area in a revision if I go larger, and are there limits to size for the transaxillary insertion?"

Let's separate the CAN question from the SHOULD question.

CAN larger implants be placed / shoved through an arm pit incision? - Yes. it will mean removing the old implants, enlarging the pocket and then placing the larger implants.

SHOULD large implants replace the ones you currently have? As long as you fully understand that larger implants WILL cause quicker breast sagging, loss of breast tissue with visibility and palpability of the implant folds and ripples and are willing to make the trade between what you have now and larger breasts will be saggy and more rippled than you can go ahead and have it done.

Dr. Peter A Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 59 reviews

Breast implant revision under the axillary approach

+1

The short answer is yes, the larger implant will fit through a trans-axillary approach, though you do lose a bit of the stealth effect as the scar will be longer, perhaps 5 cm to get the implant in. The surgery is 'harder' for the surgeon, but not for you and many may be reluctant to use your old incision for the revision unless you insist.

Best of luck,

peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 27 reviews

Choosing Excessively Large Breast Implants Is Risky

+1

Dear Elle224,

Choosing to have larger breast implants inserted can be associated with long term, irreversible tissue changes such as breast atrophy, thinning, and sagging. I would be sure to discuss all of the pros and cons with your plastic surgeon. As an aside, it is very difficult to place implants larger than 500 cc through the axilla.

Warmest wishes,

Larry Fan, MD

Larry Fan, MD
San Francisco Plastic Surgeon
4.5 out of 5 stars 10 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.