Natural Looking Breast Implants with Transaxillary Incision?

Unless the breasts have some pre-exisiting ptosis (droop) prior to the breast augmentation, there should be no reason why breast augmentation performed through a transaxillary (armpit) incision should not look natural. You mentioned in your question, that often they look to high when you see before and after pictures of augmentation performed through the transaxillary approach. This is a common mistake with the transaxillary approach. The surgeon must have the experience to know to... more

Transaxillary augmentation is an excellent approach to augmentation in those individuals who are more comfortable with a scar that is off the breast. The incision in placed high in the crease under the arm and the implant slid down into a submuscular position. This approach was very popular several years ago and has not received the attention today that it deserves. There should be no difference in the augmentation result when comparing the underarm approach, around the nipple, or a... more

You are very observant. The biggest problem with transaxillary placment is the  malposition of the implants usually too high. This approach was much easier with saline implants. Now with gels, the incision has to be made larger to accomodate the implant.

This procedure may take a bit longer, but for some patients this incision is ideal and can provide very natural looking results. Be sure to ask for many  photos of  patients who have had their implants placed through this incision, and then speak with some patients and what their experience is like.

There are many approaches used for breast augmentation. The trans-axillary approach is especially appealing since it avoids incisions in and around the breast. However, the only way to safely and precisely perform a breast augmentation through the axilla is to use an endoscope. In this way the pocket can be clearly visualized and proper implant placement can be achieved. Many doctors are not comfortable with the use of the endoscope. They either do not perform this procedure or use blind... more

One of the problems with this approach is thet there is inadequate release of the muscle to allow the implant to settle into a lower, more natural shape. I assure you that there are plastic surgeons who like this approach although there are many who don't. Make you decision by looking at a plastic surgeon's before and after photos. That will tell you in general what they can achieve. Dr Edwards

Hi! When I am doing breast augmentation surgery in New York City, I use the transaxillary approach. But not too many patients are good candidates. So I recommend it seldom. Unless the surgery is done perfectly on the right patient (long distance between the nipple and the fold, with no sagging), the implants will end up too high. It is hard to make the pocket low enough through the axilla. Let me assure you of something else. If you are not happy afterwards, it is not going to be... more

While over the past few years I have come to prefer peri areolar incisions and the placement of textured silicone gel implants there is no question that in a surgeon who has mastered the technique trans axillary sub muscular implants will give marvelous results in almost all patients. In fact if I am going to use saline implants and over 80% of my patients choose these, probably for cost factors, I routinely use the trans axillary sub muscular technique. The claim that they will be too... more

Transaxillary implants are harder, but not impossible to get symmetric. Compared to a periareolar or inframammary incision, the implant is being positioned by the surgeon from a greater distance. Therefore, symmetry is harder to achieve; intraoperative adjustments are more difficult to make. Stands to reason. What's wrong with a periareolar incision? It makes the best scar, and is only visible to a few people compared to the axilla (armpit) on the beach. Why make a predictable operation... more

It is generally true that the transaxillary approach tends to produce implants that are too high partly because it is harder to get a good dissection at the inframammary fold from a blind, blunt technique but also that if the capsule start to get a little firm, the implant will tend to try to go back into the tunnel towards the axillary which is the point of least resistance. However, you can get an excellent result if the choice of implant fits your anatomy. Usually patients who say they... more

I love circumaerolar incisions, they give a more natural breast and they fade and are almost invisible. The transaxillary approach can very often give you an implant that is too high and asymmetrical -- which is why I will not use it.