Are gummy bear implants possible with a Transaxillary incision?

Dear arieljasmine,I tend to prefer the periareolar incision because its the most well hidden. There is a natural border between the areola and the rest of the breast skin the hides the incision extremely well. You have to be completely naked to see it vs other incisions like transaxillary and inframammary are visible in clothing such as sleeveless shirts and bikini tops when extending your arms up. I've also noticed increased rates of bottoming out with inframmary incisions that is not reported. Transaxillary implants are always wide in appearance because the surgeon is not able to dissect medially enough to provide better cleavage. Ultimately, I can perform any of the incisions but I recommend the periareolar. There is no difference in sensation because the nerves that control nipple sensation come in laterally from the back and injury to them occurs when surgeons dissect to far laterally which is why transaxillary incisions have the highest nipple sensation disruption. There is no difference in breast feeding ability. One study did show a slight increase in capsular contracture with use of periareolar but that study was small and did not incorporate modern techniques such as below muscle placement, keller funnel usage and triple antibiotic irrigation. Daniel Barrett, MD

Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

I think a lot of surgeons are against transaxillary breast augmentation because they do not feel comfortable performing it or they even never tried or got train in performing it. I learned how to safely and successfully perform this type of breast augmentation over 25 years ago. Since then I augmented many thousands of breasts this way and this is my experience: it is my preferred way to do it (for a right candidate) my main reason is: why mutilate perfect beautiful woman's body if you can avoid it? And there is really no downside, it is not true that are more complications, problems or capsular contractures than with any other way to do it. If surgeon is skilled and knows how to perform axillary breast augmentation results are very predictable. I would not be repeating this procedure for over 25 years if it would be causing problems. It would be insane since I sometimes have 10 patients /week and would ha to deal with a lot of unhappy women... And do not trust surgeons who tell you under the breast incision is great. Frequently, they are quite visible, stretched, dark, keloidal and quite annoying. Especially in small breasts that have no folds make these scars impossible to hide. Last time I performed inframammary incision is over 20 years ago. There is no need for that. Armpit incisions ALWAYS heal great, and they are either invisible or look like a wrinkle in your armpit. And in my experience problems that people are describing are if anything less common that with other approaches.

Augmentation can be performed through a number of incisions, including inframmary, periareolar, and axillary. A " gummy bear" implant can certainly be placed trough an axillary incision, but it is more difficult to achieve correct positioning of the implant. This is true in general for all implants , and is accentuated by the stiffness of the cohesive gel. You might consider a softer gel implant , which is less challenging to place, and results in a softer feeling breast.

A transaxillary approach while safe can be relatively limiting. In order to maintain a smaller access will be somewhat restricted. Smaller implants can pass while larger implants will not. With regards to your specific question, "gummy bear" or cohesive gel implants are generally recommended to be placed via a slightly larger IMF or crease incision. This avoids the risk of gel fracture from excessive force needed to place the device via a more constricted approach. Additionally, there is the risk of malrotation in the case of shaped gels. Pocket control and dissection is crucial when placing shaped devices. This control is more limited in a transaxillary approach due to the lack of direct vision.As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Hello there The problem with the axillary scar is that it is prone to the highest rates of revisional surgery being required .Control of the implant pocket and prevention of rotation with tear drop implants would be the major concerns .So most surgeons have moved away from it .The IMF scar is generally inconspicuous as it is hidden in the 'shadow' of the breast .So you need to weigh up the benefit you believe the axillary scar brings against the increased risk of needing a second operation which usually has to be done with a different scar .CheersTS

Thank you for sharing your excellent question.  It is possible to place a gummy bear implant through a transaxillary incision, but it is limited based on the size implant selected.  Larger implants will have the increased risks of a longer axillary scar and may increase the outer chest dissection leading to implant malposition.  Hope this helps.

Yes, you can do this. It is an advanced procedure which IMHO should be done with an endoscope not a blind seep. Several Scandinavian countries have good study results doing this procedure. The implant size will dictate the incision length to some extent. Good Luck!

If certain types of round gummy bears of smaller size are used, this is possible and safe.  Consult with a board certified plastic surgeon to discuss whether this incision would be appropriate for you to reach your goals.Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

Thank you for your question.  Generally speaking, there is a lower complication rate with placing silicone gel gummy bear implants through a small inframammary or breast fold incision.  Utilizing a transaxillary incision will also limit the size and type of silicone gel implant that can be placed and there is a higher rate of revisional procedures when placed this way.  The inframammary incision is roughly 2.5cm (super small) and very well hidden in the breast fold.  Although you can never predict the way that a scar will heal, these incisions tend to heal beautifully and patients are often hard pressed to find them once they have fully matured (roughly one year post-op).  I would recommend that you schedule a consultation with a Board Certified Plastic Surgeon to discuss your candidacy for a breast augmentation and to review the various options available to you, including incision types/approaches.  It is important to weigh the pros and cons of each option and incision type, and together you and your surgeon of choice will determine the best option for you!  I hope that this helps and I wish you all of the best!

Using a funnel insertion technique, larger highly cohesive silicone breast implants can be placed through a small high axillary skin crease incision.