Doctor Recommendations in LA - Breast Augmentation with Cohesive Silicone Gel via Endoscopic Transaxillary?

I'm a Asian/5'4"/105 lbs/full A cup(almost no saggy), would like to have dual plane breast aumentation through the armpits to full C cup, want to be natual shape with round smooth cohesive silicone gel. I heard using endocope could reduce hematoma, more approch asymmetry & shape, minimize capsular contracture, no scar around breasts, heal faster than without using endoscope ect... It seems to have many pros to me. I'm looking for a experienced doctor who using endoscope in Los Angels area. Help.

Doctor Answers 10

Transaxillary Cohesive Gel Endoscopic Breast Augmentation - How Do I Find A Good Surgeon?

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I usually recommend you find a good surgeon first and then follow his or her recommendations, but in this case, I agree with you wholeheartedly that silicone breast augmentations through the armpit, underneath the muscle, using an endoscope leads to a most natural, attractive breast augmentation.

Being from LA, I am sure there are literally over 50 Board Certified, well trained plastic surgeons meeting your above qualifications.  The way to find a safe plastic surgeon is to go to the American Board of Plastic Surgery website, chose several surgeons in your area, then check out their websites concentrating on breast augmentation pages on their websites that match your above requested criteria.  Next visit individual surgeons, check out their before and after pictures, and ask to speak to approximately three patients who have had transaxillary silicone endoscopic breast augmentations.  Ultimately find a surgeon who you feel comfortable with and then allow the surgeon to take it from there because now you have done your due diligence.  

Dual plane approach through the armpit.

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 I am not an advocate of the transaxillary approach for breast augmentation. However there are many surgeons who do employ this method. The majority of surgeons around this country will choose to place a silicone implant through an inframamary incision. The reason for this is greater control of the inframamary fold,  lower documented infection rate, and better incision control. The trans axillary approach can be used  but I recommend an experienced surgeon.   The  dual plane dissection may not be possible through an axillary approach.

Breast augmentation

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No I would not do it that way.

In breast augmentation I have chosen to spend time reviewing photographs with patients to fully understand their expectation of size and shape. Many times this simply raises more questions. I will make measurements and use the implant guides to allow the patient to understand exactly the sizes that are reasonable for their body type and measurements.

Please find an experienced Board Certified Plastic Surgeon and member of the Aesthetic Society using the Smart Beauty Guide. These Plastic Surgeons can guide you on all aspects of facial surgery, breast augmentation and body procedures including tummy tucks or mommy makeovers!

Choosing your Surgeon?

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Thank you for the question.

When choosing a plastic surgeon it is important to  do your due diligence carefully. You will find that well-trained, well experienced board-certified plastic surgeons are extremely capable managing a variety of different procedures and the potential complications  associated with the procedures

I  am sure there are many well-qualified plastic surgeons in your area. I would suggest starting with the American Society of Plastic Surgery  to obtain a list of well experienced board-certified plastic surgeons. Then, I would suggest you visit a few surgeons whose practices  concentrate on aesthetic surgery. Ask  to see lots of examples of their work and preferably speak/see patients who have had similar procedures done.

You will find,  while doing your due diligence,  that there are many different “specialties” who will offer their services to you;  again, I strongly recommend you concentrate on surgeons certified by the American Board of Plastic Surgery.  

I hope this helps.

Transaxillary Breast augmentation

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My favorite surgery is Trans axillary approach to breast augmentation.  I specialize in that surgery and have done so for 23 years.  My 20 year experience in trans axillary surgery is being published in September in the Aesthetic Surgery Journal which is the official journal of the American Society for Aesthetic Surgery.  This paper will have the largest series published ever on the trans axillary approach which will be about 1700 patients.  The largest series before this was about 300 patients.  I can give you a sneak peak at this article to say that I have only had 3 hematomas in that series, most of which were very early in my experience mainly.  So far I have yet to have a primary augmentation get infected.  Some of these patients were done with an endoscope and some were not.  There are pros and cons of every choice that you pick.  Using an endoscope WILL take more time, and you introduce more things in the pocket, and you do burning which leads to more char in the pocket, all of which has a consequence.  Not using an endoscope cuts down on debris left behind and time of the surgery, which helps in recovery.  Just make sure that you have picked someone that is very experienced with this approach, as there is a large learning curve.  Start off by making sure that your surgeon is a Board Certified Plastic Surgeon, and one that is a member of the American Society for Aesthetic Plastic Surgery.

Dan Mills, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 35 reviews

Breast augmentation

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True " dual plane " technique involves loosening the muscle from the overlying breast tissue. I think what you really mean is under the muscle. You can't do a true dual plane technique from the armpit. Under the muscle will give you  a more natural appearance and using an endoscope is better than without an endoscope. Usually for asians though I think the areola is a good approach since the scar may heal dark in your armpit with asian skin.

David E. Kim, MD
Beverly Hills Plastic Surgeon
4.6 out of 5 stars 106 reviews

Augmentation in LA

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The best way to start is to go to the plastic surgery website at ASPS or ASAPS and look up the surgeons in your area.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Transaxillary smooth silicone dual plane breast augmentation.

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This is a very challenging procedure with true cohesive textured anatomic implant and further compliicated by the dual plane dissection. It may be slighthly easier with a smooth round gel but unless you are requesting a very small implant, a cohesive silicone implant of any modest size will likely require a minimum 5 cm and likely even a longer incision.  Meet with physicians and ask to see the scars if patients are available.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Endoscopic breast augmentation through the armpit

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I do transaxillary breast augmentation with both silicone and saline breast implants.  Although back in my training I learned how to do it "blind", these days I believe the best way to do it is to use endoscopic equipment.  This allows for a much more precise dissection, immediate and secure control of any bleeding, and less trauma which translates into less post-operative pain and bruising, and less chance of capsular contracture.  The visualization from the endoscope is actually better than that of a standard breast augmentation through an inframammary or periareolar incision, because the camera and video monitor magnifies the image.  I highly recommend transaxillary breast augmentation, but find someone experienced with endoscopic procedures in general, and endoscopic transaxillary breast augmentation in particular.  Patients are very happy when they see no scars on their breasts, and the scars in the armpits heal discreetly in the natural armpit folds.

Trans axillary silicone gel implants give really great results

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While I personally don't use an endoscope with my trans axillary augmentations there use is good in the hands of those who use them. I just don't find hardly any hematomas with just straight blind blunt dissection. The issue you are asking about is the use of Silicone gel verses saline implants through the trans axillary incision. I do this quite frequently and find that the silicone gel implants give a much nicer more natural looking and feeling breast. The only disadvantage of the endoscope is that the incisions must be larger and it take quite a bit more time to complete the surgery. 

Carl W. "Rick" Lentz III, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 17 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.