Breast implants incision sites, how difficult is it to insert gummy bear implants via the armpits?

in my practice I routinely place form stable anatomical "gummy bear" implants through the armpit (transaxillary) in a technique I call "Cold-Subfascial Breast Augmentation."  Many surgeons believe this is impossible or requires a large scar but this is not true.  The technique is more difficult than others and requires a different skill set but I have been performing this procedure for over six years in all primary breast augmentations in my practice, delivering beautiful natural results.  I do not like to unnecessarily place a scar on the breast in augmentation.  I do use a funnel but it is not necessary, the technical details are much more important.  I hope this helps!All the best,Rian A. Maercks M.D.

Gummy Bear, or form stable implants, are much more difficult to place from the armpit because they do not give as much as the softer implants. It can be done but you will have a much larger incision, usually. I would recommend either the infra-mammary crease or infra-areolar incision sites normally for form stable implants. Talk to your surgeon in detail and make sure you are happy with the answers you get. I know you are afraid of a mark on the breast but if done correctly and using fine technique that can be minimized.

Many patients will struggle with the choice of access incision. While there are many options, it is important to understand the limitations of each, especially as it relates to form stable devices.The choice of incision in the setting of breast augmentation is one which is made jointly by both the patient and the surgeon. Surgeons typically have their preference as do patients.
One thing to consider is the implant type and size as it relates to incision choice. Silicone implants typically need larger incisions than saline implants (due to the fact that saline implants are placed first then filled). The difference is subtle (on the order of  a centimeter) but is worth considering. The need for a larger incision is even more crucial when considering form stable shaped devices as they require a still larger incision. The manufacturers recommendation is for a generous IMF incision (although many surgeons have moved beyond this).
Additionally, there is data which indicates that there is a slightly elevated risk of capsular contracture. This is thought to be a consequence of bacterial contamination which is attributed to traversing the glandular tissue on the periareolar approach (nipple is connected to the outside world and the ducts which are then linked to the glandular tissue).With regards to your specific question, there is always a risk of keloid scarring anytime an incision is made. Fortunately, there are options for managing them including silicone sheeting, steroid and 5-Fu injections.
That being said, both approaches are safely employed by many surgeons. As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Thank you very much for this question. The incision in the axilla as the advantage that it is quite a concealed however and it has largely been left because of its disadvantages. That is for example the relative far distance to the area that is prone to bleeding. In order to place the implants under the muscle the muscle has to be detached on it's lower and and this can cause bleeding.  Because of this less than perfect accessibility this  entrance for in a silicone implant can be challenging. I would advise you to speak with your plastic surgeon and let him determine which incision would be ideal for you. Have a wonderful day and greetings from the beautiful island of Jamaica.

Thank you for your questions. There are several incisions that can be used for you BA surgery. One of them is the trans-axillary incision which is well hidden in the hair bearing area of your arm pits. I have used a keller funnel for this as it helps avoid skin contact and trauma to the implant. An in person consultation and evaluation is a good starting point. Be sure to see a Board Certified Plastic Surgeon (ABPS) who can spend time with you and help you get your desired look.Sincerely,Benjamin J. Cousins MDBoard Certified Plastic Surgeon-Miami/Miami Beach

Because of the rigidity of the breast implants, placement of gummy bear implants via armpits is generally not advised. Consult in person with an experienced and expert board certified plastic surgeon to understand your options.

Thank you for your question.
Placing any type of implant through the armpit carries a higher complication rate versus the other two incision sites you mentioned. One of the reasons is, it is difficult to see what you are doing when going through the armpit. For this reason I invented the HALPERN Universal Endoscopic Retractor. I pioneered this technique for placing implants into the breast through the armpit using a t.v camera. The surgery is projected onto a flat screen t.v. This significantly improves the safety and the quality of the surgery. Inserting a Gummy Bear implant is not difficult when using the Keller Funnel. For more information please watch the enclosed video. I hope you find this information useful.

I prefer the inframammary incision for many reasons. Also, "gummy bear" implants are not my go to choice for a variety of reasons.  Be sure to consult with a board certified plastic surgeon (ABPS ONLY), and perhaps get several opinions. Best of luck.

Textured breast implants are difficult to place through the axilla even with a Keller funnel. In addition placing breast implants through the axilla does increase your risk of capsular contracture and the need for revision of implant position. Please consult than experienced board certified plastic surgeon to discuss your options.