Transaxillary, Subglandular Breast Augmentation? (photo)

Inframammary, Subglandular Breast Augmentation Body: The part I'm having issue with is the subglandular placement of the 450cc moderate profile plus silicone implants. Will there be a lot of swelling? Is subglandular a good position? I had a breast reduction in '08 and my scar has healed well. My plastic surgeon said I could get a breast lift and then come back and get implants, should I be ok without the breast lift? He said I have plenty of breast tissue.

Doctor Answers 14

Ultimate Breast Lift increases projection and eliminates the need for implants

You are an extremely poor candidate for transaxillary subglandular breast augmentation.  A better procedure is a new technique called The Ultimate Breast Lift.  This technique will reshape your breast tissue creating upper pole fullness, elevate them higher on the chest wall and more medial to increase your cleavage.  Aligning the areola and breast tissue over the bony prominence of the chest wall maximizes anterior projection and may eliminate the need for implants.  Another advantage of this technique is that the weight of the breast is transferred to the underlying muscle providing long term stability and pain relief.

Best Wishes,

Gary Horndeski, M.D.

Texas Plastic Surgeon
5.0 out of 5 stars 153 reviews

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Transaxillary Breast Augmentation Post Breast Reduction

What I think IS true is that you can't simply have a subpectoral breast augmentation (based on your photos).  My recommendation would likely be for a breast lift with subpectoral implants.  As others have noted, you already have the scars of a breast lift.  So it seems appropriate to use the same incision for implants and another lift.  Good luck!

James N. Romanelli, MD, FACS
Long Island Plastic Surgeon
5.0 out of 5 stars 14 reviews

Transaxillary, Subglandular Breast Augmentation? (photo)

I think you really need to see another surgeon. I am puzzled why a transaxillary approach when you have existing scars from the breast reduction. And placing breast implants above the muscle leads to a whole host of issues. Depending on what your goals are, you may be best served  doing a full breast lift initially. If not you could place implants at a later date. 

James E. Murphy, MD, FACS
Reno Plastic Surgeon
5.0 out of 5 stars 17 reviews

Not subglandular

My biggest concern after looking at your pictures is that you have a lot of drooping now.  Adding more weight to the subglandular position when your coopers ligaments have already stretched out, will only make them droop much more.  When placed under the muscle, the implant is separated from the breast tissue, and there is less weight added to the already droopy breast.  Not to mention all the other problems of subglandular, such as higher capsular contracture rate and putting more tissue between the breast and the implant for better cancer detection.  

Also, if you already have a scar that can be used for the implant under the breast, why use another scar in the axilla?  You need more breast tissue removed in the lower part of the breast, and you cant do that with a transaxillary approach.  I do most of my surgeries through the transaxillary approach, and would not use that in you.

Good Luck

Dan Mills MD FACS

Dan Mills, MD
Orange County Plastic Surgeon
4.5 out of 5 stars 21 reviews

Breast Augmentation

I really think you should see another surgeon.  I have no idea why you would have a transaxillary incision if you already have scars from your reduction.  Looking at your breasts, I would do a full anchor lift and essentially re-do your previous reduction but instead of removing breast tissue, I would simply re-shape your breast so that you get more projection.  Depending on your goals, you may not need an implant.


Asif Pirani, MD, FRCS(C)
Toronto Plastic Surgeon
5.0 out of 5 stars 31 reviews

NO reason to do transaxillary

You do not need transaxillary.

Inframmammary for someone who has had a breast reduction is better. It is more precise and the bottoming out might be corrected by removing an inferior wedge.

I cannot measure you or know your exact objectives but augmentation and correction may be able to be done at one step. It would be possible nipple elevation and correction of bottoming out by inferior skin excision.

I would use a textured implant either a round gel or a newer cohesive gel shaped implant. I would go under the muscle too. The superior portion covered by the muscle I feel leads to less long term problems.

Benjamin Van Raalte, MD
Davenport Plastic Surgeon
4.5 out of 5 stars 26 reviews

Transaxillary, Subglandular Breast Augmentation?

Many concerns! Why transaxillary?? You already have scars from he reduction. Size with inferior lifting should be considered. 

Transaxillary augmentation

Since you already have scars on your breast there would be no reason to make an incision in your arm pit.  I believe that would be a bad decision.  From your photos it really appears that you need a lift.  If the implants are placed just beneath the breast tissue I believe you will get more sagging as time goes by.  In my personal opinion you would be better off with implants placed behind the muscle and a breast lift if needed.

Gary Hall,MD

Gary Hall, MD
Kansas City Plastic Surgeon
4.5 out of 5 stars 31 reviews

Transaxillary, Subglandular Breast Augmentation?

In my opinion you need the lift much more than the volume. I would strongly advise you to do the lift first. In their current location your breast seem much too low to have good results from the implants.  Also, you already have scars from a previous reduction, so when it comes time to do the augmentation if you follow through with that why not just use one of your old crease incisions.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 17 reviews

I think the Transaxillary Breast augmentation approach is not good for you

I perform Transaxillary Endoscopic Assisted breast augmentations on a regular basis. I think it is a great operation on the appropriate patient. This patient is usually thin with small breasts. I place the implant in the Submuscular, not the Subglandular position in ALL of my Transaxillary Surgeries. I do not think you are a candidate for the transaxillary approach. SInce you already have had breast surgery I feel that your surgeon should use one of your exisiting incisions and place an implant in the SUBMUSCULAR position. Especially since you already had a reduction and the blood supply to the areola has been altered. I recommend you do not proceed with the surgery you described.

Itzhak Nir, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 10 reviews

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