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Is It Possible to Virtually Eliminate the Risk of Nerve Damage During Breast Augmentation Through the Armpit?

asked 1 year ago by Nicole1988 in CA
Latest answer by Julio Garcia, MD
Question viewed 599 times
Tags: nerve damage, risk, transaxillary

I am looking for a surgeon who will take all necessary steps to avoid permanent nerve damage to any part of my body during a transax breast aug. Is it possible to assure your patients in good faith that the risk of nerve damage will not exceed the single digit range (i.e., 0.-9.99%) I would greatly appreciate all thoughtful commentary put forth by surgeons specializing in the axillary approach or particularly educated on the topic of nerve damage associated with BAs. Thx!

17 answers to Is It Possible to Virtually Eliminate the Risk of Nerve Damage During Breast Augmentation Through the Armpit?

Can you "virtually eliminate" the risk of nerve damage in breast augmentation

Thanks for this second question today. The risk of nerve damage in breast augmentation is very small and is not specifically related to the incision used, more by the surgeon's technique and the size of the implants used. The bigger the implants, the more the risk. The axillary incision actually carries an additional risk of numbness that the others don't have. This is from injury to the nerves that branch across the armpit and give feeling to the inner... more

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

I'm afraid it is not possible to completely remove the risk of nerve damage during breast augmentation through the armpit

Thank you very much for your enquiry, I'm afraid it is not possible to completely remove the risk of nerve damage during breast augmentation through the armpit but this is extremely rare. Normally, the symptoms of nerve damage do include tenderness in the area and possibly loss of sensation on the inner part of the arm. There are number of surgeons however who do specialize in this approach and it would be worthwhile discussing with them there experience of nerve damage in the... more

Adrian Richards, MD
London Plastic Surgeon

Nerve damage after breast augmentation- which incision is best?

Nerve injury after breast augmentation may lead to nipple numbness or breast pain. Most often, this is a temporary effect, caused by stretching of intercostal nerves that enter the breast from the side. The periareolar approach probably has the highest rate of numbness because the skin and breast tissue are cut near the nipple. The inframammary approach has a very low risk of nerve injury, because the surgeon is staying below the muscle. With the transaxillary approach, it is possible... more

Karen Vaniver, MD
Seattle Plastic Surgeon

Axillary breast augmentation, New York breast augmentation

I have been doing axilary breast augmentation for past 30 years, since 1982. I do about 6-8 per week. I can assure you that I have not had any nerve damage occur as a result of this type of surgery so far. Nerve damage is very rare from this type of surgery if performed by experienced surgeon. Usually saline implants are used as these can be inserted through a very small incision which also reduces any risks of damaging any surrounding tissue. These surgeries are done on an... more

Helen S. Colen, MD
New York Plastic Surgeon

Breast augmentation incision location

Anytime you make an incision in the skin you are cutting sensory nerves. It does not matter how you make that cut-laser, scalpel or even a diamond. I assume in your hypothetical you are referring to the nerves that are the sensory nerves of the breast rather than the skin in general. If that is the case it does not matter what the skin incision is (belly button, crease under the breast, armpit or even surprisingly the nipple itself). A study some years ago using sensitive measures of skin... more

Aaron Stone, MD
Los Angeles Plastic Surgeon

Transaxillary augmentation

A transaxillary augmentation is not my favorite way to go. No matter what approach there is always a small risk of nerve damage and no one knows exactly why it happens in the cases that it does occur in..

Steven Wallach, MD
Manhattan Plastic Surgeon

Risk of nerve injury during trans axillary breast augmentation vs. other incisions

No surgeon, no time,no where can completely eleminate the possibility of nerve injury in any invasive proceedure, no matter how skilled or experienced they are. Numbness of the nipple/areola ,if it should occur, usually returns to a functional level within a year

Barry H. Dolich, MD
Bronx Plastic Surgeon

Nerve damage in Breast Augmentation

Breast augmentation through a transaxillary approach carries the highest risk of nerve damage, 15% in the literature than the more common inframammary approach. A periareolar approach has more nerve damage than the inframammary approach. Nerve damage also depends on the size of the implant that you and your surgeon choose. A saline implant trough the axilla is placed in the submuscular pocket empty and would have less chance of nerve damage that a prefilled silicone gel implant. As... more

Leo Lapuerta, MD
Houston Plastic Surgeon

Is It Possible to Virtually Eliminate the Risk of Nerve Damage During Breast Augmentation Through the Armpit?

You're probably talking about injury to the intercosto- brachial Nerve while using the transaxillary approach to BA. That injury risk is negligible in the hands of experienced surgeon in this technique.

Erel Laufer, M.D.
Tampa Plastic Surgeon

Nerve damage risk can be eliminated in breast augmentation

The under the arm or transaxillary approach to breast augmentation can be performed without risk to the nerves under the arm, risk to sensation in the breast and nipple is another matter. With any approach, under the arm or under the breast, the nerves within the breast can be stretched and challenged, and numbness or damage can occur. The larger the implant, the greater the risk. Damage to the nerves under the arm though just should not happen. Best of luck, peterejohnsonmd more

Peter E. Johnson, MD
Chicago Plastic Surgeon

www.peterejohnsonmd.com

Avoiding nerve damage with breast augmnetation

Every approach has its benefits and risks, and all incisions for breast augmentation have some risk of nerve damage. The nerves that provide sensation to the nipple area enter the breast on the side, where they branch out from under a rib. When the pocket is being created for the implant, these nerves can be stretched or otherwise affected. Since the axillary appraoch comes in from the side, it is possible that this is the highest risk approach for nerve damage, though many people... more

Richard Baxter, MD
Seattle Plastic Surgeon

Breast Augmentation - Transaxillary (Armpit), Nerve Damage, Risks

Hi Nicole1988 in CA, I don't know of any statistics that could provide a basis for this...in general, though, every surgeon that I know of does everything possible to minimize the risk of this - and all - complications. I understand that you're concerned about nerve damage, and it's an issue for all approaches (although there are some nerves that are at risk with the axillary approach but not with the peri-areolar (nipple) or infra-mammary (crease, or underneath)... more

Alan Engler, MD
New York Plastic Surgeon

Nerve injury prevention

I think all surgeons try everything they can to avoid a nerve injury during a breast augmentation. The major issue with a nerve injury is usually concerns of nipple sensory loss. The nerve that gives sensation to the nipple is mostly the nerve that comes from lateral to medial at the 4th rib.The risk of that nerve being injured is due to the pocket being opened, and not the incision. The rate of nipple sensation loss is the same with all three common incisions as it is not the skin incision... more

Julio Garcia, MD
Las Vegas Plastic Surgeon

Breast augmentation - trans-ax

Studies show the rate of loss of sensation is about 10% . This should be the same for all incisions. Questions like these are not helpful to you , they will only lead you to whoever tells you what you want to hear. Same is true for questions regarding capsular contracture. Studies show the capsule rate is at least 10%. Should someone giving you a guarantee of 1% nerve injury rate or 1% capsule rate be a criteria for selection? I don't think so. To really know the actually nerve... more

David E. Kim, MD
Beverly Hills Plastic Surgeon

(Nerve damage risk after axillary breast augmentation is actually higher!)

Short answer: "No." The long answer takes medical school (4 years), surgical residency (5 years), plastic surgical fellowship (2 years), and a couple of decades experience and thousands of breast cases, but here are the facts: Whenever incisions are made, regardless of location, small sensory nerves are ALWAYS cut. They usually heal, but will not return to full, normal, pre-operative sensibility. Deeper incisions, such as creation of a pocket big enough for breast implants,... more

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon

There is No Way to "Virtually Eliminate Risk" in Surgery

As surgeons, we work very hard to reduce the risks of surgery, but there is no way to "virtually eliminate risk." Even if the occurrence is reduced to 1%, the risk i still present (though very small) and will occur in that 1-in-a-hundred person. As surgeons, we cannot predict who that one-in-a-hundred person will be: before undergoing a surgical procedure, be honest with yourself about your ability to accept the relevant risks.

Paul C. Zwiebel, MD
Denver Plastic Surgeon

Nerve damage

You are using a lay mans term that is not accurate. All surgery involves the cutting of blood vessels and nerves. It is impossible to do a breast augmentation without damaging some nerves - now, will it be significant, will you notice it ? Maybe yes maybe no. The only way to guarantee no problems or complications is to wear falsies not not do a surgical procedure.