Can a pocket adjustment be done using a transaxillary method? Concerned about scarring (photo)

Dear Skylint,
In discussing the pros and cons of all options for breast augmentation techniques with my patients two disadvantages of transaxillary breast augmentation are always mentioned: 1. less precision in positioning of the breast implant (unless maybe with endoscopic), and 2. the possibility that an inframammary incision might be required for future breast implant issues (displacement, capsular contracture, breast implant leakage, double bubble, bottoming out, etc). It is easy for a second plastic surgeon to say that your original surgeon did this, or that, wrong, i.e. he/she put in a breast implant that was too large for you. In fact, that is shameful, and likely a solicitation to now get your business. Your implants do not look oversized. Double bubbles, bottoming out and capsule stretching (not the pocket being made too large) can occur in the best of surgeries performed in the best of hands. At any rate, revising your breast augmentation through an axillary incision at this point would be virtually impossible. I would suggest 2 things. Seek another opinion with yet another American Board of Plastic Surgery certified plastic surgeon, who, if ethical enough, may not be so eager to slander your original surgeon. Then return to your original surgeon with your concerns and newly gained knowledge. He/she should have a correction plan, and will likely give you steeply discounted fees, if any at all. Good luck!

No, the axillary incision is very limited and difficult to use for pocket repairs. Many times, a new incision is needed just to replace the implant. This is not about "skill" but ability to visualize well and control the pocket well.