3.5 yrs ago I under went a breast aug. transaxillary (390 CC MPP Saline Implants,Submuscular Placement, Before Bra Size 34B, After Bra Size 34DD). I went with transaxillary to avoid scaring on the breast. What are my options for a revision? Can a revision be done transaxillary again?
Ridin' High or Neck Breasts
Doctor Answers (9)
High riding breast implants are often from too large submuscular implants
Your result is what would be expected with large submuscular implants.
If you like the size then there is no revision. Accept the side effect.
If you want smaller implants so that they don't ride so high it can be done tranaxillary by the surgeon who offers this approach. It should be simple.
Revison breast augmentation transaxillary
It is possible to perform a revisoin through a transaxillary approach, but if you have a capsule or any other issue, it is best to use an alternative method either under the fold or periareola.
Although it can be done transaxillary, I think a more consistent result could be obtained through an inframammary fold incision. I also do not think it is size problem. The inferior muscle was probably not cut/released enough, and this is all that needs to be done.
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HIgh position implants
While transaxillary is not the most common incision location, it use is perfectly acceptable. I would agree that the implants are sitting high and would provide better shape if lower. However, I wonder if the implant size is part of the issue. Either way a surgeon should be able to lower them using any incision. If the surgeon is comfortable with the transaxillary approach then he may reuse that incision. Otherwise, I typically prefer an inframammary incision.
While pictures are never as good as an in-person evaluation it appears as though your surgeon was unable to control the position of your implants through the axillary incision. In this case I would recommend a revision through either an inframammary crease or a periareolar incision. These will give increased access to the lower pole of your breasts for better pocket and implant positioning.
Thank you for the question. I hope this helps. Good luck.
Transaxillary incisions leave the breasts too high. I use either a circumareolar or and inframammary incision to insert implants and if need be revise them through the same incision.
Most plastic surgeons would recommend either an infraareolar or IMF incision for a revision after transaxillary augmentation. Having said that, if you are changing your implants, endoscopic transaxillary approach can be performed after the other implants are removed. The lower pole can be released to allow the new implants to drop. Make sure you find the plastic surgeon with the best credentials who can perform all of these procedures to give you the most flexibility.
Correction of High Riding Breast Implants?
Thank you for the question and picture. Although it is not possible to provide you with precise advice based on the limited information/picture, it is very likely you will benefit from revisionary breast surgery. This operation will likely involve lowering of the breast implant pockets to allow for the breast implants to settle further. Doing so will help improve the position of the nipple/areola complexes on the breast mounds.
In my practice, I would prefer to approach this situation through an incision under the areola as opposed to the transaxillary approach.
When the time is right, seek consultation with board certified plastic surgeons who can demonstrate significant experience helping patients in your situation. Communicate your goals carefully.
Were I your surgeon I would not offer a transaxillary incision for this revision. The implant, which should be usable (unless you are considering a size change or switch to silicone) would probably be broken on removal More importantly, the implants are high, probably because it was not possible for your surgeon to control the lower pole position. A direct breast fold incision is more likely to result in proper positioning of the implants. Thanks and best wishes.
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