What are the pros and cons of through the arm pit sub muscular implant procedure?

I believe there are really no cons to performing breast augmentation through an armpit incision by an experienced surgeon using an endoscopic approach.  However, some surgeons do perform breast augmentation with this incision, using a blind and blunt approach.  I feel this increases the risk of contracture and malposition of the implant.  Using an endoscopic approach, I believe you have the same degree of control and precision as other approaches for implant placement.  This does take additional training, specialized equipment and experience to perform properly.Aloha,Shim Ching, MD

Thank you for your question.  In my experience, many women prefer the transaxillary approach to breast augmentation as it leaves absolutely no scar on the breast.  The scar is very well hidden under the arm pit and is virtually undetectable after a 3-6 months.  Plastic surgeons who are experienced with this approach have no more problem with asymmetry than with any other approach. As with any technique, experience of the plastic surgeon is paramount.  I use the transaxillary approach with saline, silicone gel and Ideal implants with excellent results. In fact, one of the advantages of trans-axillary saline implants, is the lowest rate of capsular contracture.I have done both trans-axillary and infra-mammary breast augmentation for over 30 years and have not seen any more problems with asymmetry or malposition with the trans-axillary approach than the infra-mammary approach. Most surgeons have a preferred technique, often based on their training and clinical experience. When done properly, both of these approaches are safe and will provide a nice result. The infra-mammary approach is more common, but not necessarily a better option for you.  I hope this is helpful. Good luck to you.