I am interested in Breast Augmentation and would love to have an unnoticeable scar. Most gummy bear procedures I’ve seen have inframammary incisions and I would prefer no underboob scars. Can I get a transaxillary incision instead? is it safe?
Answer: 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
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Answer: 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
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Answer: All implants are gummy bear now and certainly can be performed transaxillary 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.
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Answer: All implants are gummy bear now and certainly can be performed transaxillary 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.
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October 4, 2018
Answer: Transaxilllary augmentation 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.
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October 4, 2018
Answer: Transaxilllary augmentation 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.
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October 2, 2018
Answer: Gummy Bear and the transaxillary approach 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).
Helpful 1 person found this helpful
October 2, 2018
Answer: Gummy Bear and the transaxillary approach 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).
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October 1, 2018
Answer: Axillary Scar 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
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October 1, 2018
Answer: Axillary Scar 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
Helpful 1 person found this helpful