As far as healing and minimizing post-op risks, is it better to get an inframammary incision or transaxillary?
Doctor Answers 19
IMF or transaxillary
1. If you don't have to put a scar on the breast ( and you don't) then why do it? Plastic surgery is all about concealing the evidence that we have been there and the endoscope is perfect for this.
2. Visualization is actually better than it is with the IMF approach where you are peering through a small incision with a headlight. In an endoscopic procedure all the structures are magnified and much closer. Thus there is no blunt dissection and no bleeding. Very precise and very minimal if any bleeding.
3. Early reports of pocket difficulties found in the literature were based on blunt techniques and large incision techniques no longer a part of the procedure. All is done through a minimal incision with fully visualized maneuvers inside the pocket which in my opinion and in my experience is actually MORE precise than peering through a hole at the bottom of the breast.
4. Recovery is faster because we have the patient at full motion the day of surgery. There is no activity limitation whatsoever as there is with most IMF procedures and we want full range of motion of the arms right away. There are no dressings on the wounds to deal with either. The post operative discomfort is not in the armpit but in the muscle that is cut below and stretched over the implant the same as with IMF incisions. so both procedures have the same degree of post op discomfort.
5. All types of procedures from standard sub muscular, to dual plane, to even subfascial techniques can be accomplished endoscopically.
6. Personally I find the endoscopic technique easier to do, easier to control, and also with lower risks to my patients.
Now, to give you an idea about the validity of this technique, let me share with you that last year at the American Society of Aesthetic Plastic surgery annual meeting , where I teach this procedure in a teaching course, sitting in the audience was one of the leading breast surgeons in the world with many publications, who , at the end of our teaching course stated he was changing to endoscopic!!!! Now that is quite a statement coming from someone who has performed thousands of augmentations.
For your specific request, the implant you desire can easily be placed in the sub muscular pocket endoscopically. If you decide on endoscopic just beside the surgeon has a lot of experience with the technique.
I wish you all the best.
I'm 44 years old & I'm planning to do nefertiti or silhouette lift.
Thank you for your question. There are variables which may make one incision more desirable than another, but any incision should heal well without significant differences to the overall result or risks. with Slhouette lift it is not used anymore.
Axillary or inframammary augmentation incision?
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Incisional approach for breast augmentation
As you know, there are several incisional approaches to breast augmentation. Each has pros and cons.
I do prefer inframammary crease incision as it allows me the best direct visualization of pocket dissection. Also, it is straight forward with least trauma to breast and nipple areolar complex.
The decision should be based on your preference as well as your surgeon's preference and skill sets.
Please choose your plastic surgeon carefully and discuss your concern.
Transaxillary or inframammary incision.
Good luck to you.
Frank Rieger M.D. Tampa Plastic Surgeon
Breast augmentation: inframammary vs. axillary incisions
Transaxillary vs. Inframammary incision
Inframammary Vs Transaxillary Incision
Your question asked about postop risks, and the best answer is that a group of doctors have researched that very question and performed breast augmentation via all 3 approaches: the axillary, areolar, and inframammary incisions.
Their research showed higher capsular contracture, higher malposition, and also a higher chance of secondary procedures in patients who had axillary and areolar incisions compared to the inframammary group.
As far as healing and recovery, my opinion is that there would be no significant differences. Gentle handling of the tissues, especially the pec muscle along with the use of a muscle relaxer if needed to treat spasm have had the biggest impact on my patients recovery.
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.