Most PS in my area don’t offer this approach. I understand that if done this way a new incision would have to be created should I need a revision surgeries down the road. I would just really like to avoid having a scars on my breast.
Answer: Why don’t more PS use the transaxillary breast augmentation using endoscopy technique? The transaxillary approach involves making an incision in the armpit. The pocket for the implant can be dissected blindly and bluntly with special instruments. It can also be dissected with an endoscope and electrocautery under direct vision. The endoscope allows visualization of bleeding vessels that can be directly controlled. Reported disadvantages include poor pocket visualization and control, which is largely dependent upon surgeon comfort with the procedure and the number of procedures performed through this approach. The scar in the hairbearing area of the axilla may cause shaving difficulties. If removal of the implant is necessary in the future due to implant rupture or capsular contracture, an incision on the breast mound, either periareolar or inframammary, may be necessary.
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Answer: Why don’t more PS use the transaxillary breast augmentation using endoscopy technique? The transaxillary approach involves making an incision in the armpit. The pocket for the implant can be dissected blindly and bluntly with special instruments. It can also be dissected with an endoscope and electrocautery under direct vision. The endoscope allows visualization of bleeding vessels that can be directly controlled. Reported disadvantages include poor pocket visualization and control, which is largely dependent upon surgeon comfort with the procedure and the number of procedures performed through this approach. The scar in the hairbearing area of the axilla may cause shaving difficulties. If removal of the implant is necessary in the future due to implant rupture or capsular contracture, an incision on the breast mound, either periareolar or inframammary, may be necessary.
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Answer: Shortly: if your surgeon knows how to do it there is no better way why to have scars if you can have none??? 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: Shortly: if your surgeon knows how to do it there is no better way why to have scars if you can have none??? 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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September 9, 2019
Answer: Transaxillary breast implants Many plastic surgeon, including myself, have tried the transaxillary breast approach at some time in their practice. I think most who have tried it eventually realize it has no great advantage over other incisions. The surgeon doesn’t have as much control or visualization. If you really wanted it done that way I’m sure you could find surgeons willing to do it, but I suspect most will try to talk you out of it.
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September 9, 2019
Answer: Transaxillary breast implants Many plastic surgeon, including myself, have tried the transaxillary breast approach at some time in their practice. I think most who have tried it eventually realize it has no great advantage over other incisions. The surgeon doesn’t have as much control or visualization. If you really wanted it done that way I’m sure you could find surgeons willing to do it, but I suspect most will try to talk you out of it.
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June 26, 2019
Answer: Breast augmentation scar planning A well-planned breast augmentation using an infra-mammary incision should have the resultant scar in the infra-mammary fold itself - its basically invisible in that position. Check out my before/after photos and see what you think. Most PS do not perform trans-ax breast augmentation because of the implant malposition and capsular contracture issues associated with this procedure.
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June 26, 2019
Answer: Breast augmentation scar planning A well-planned breast augmentation using an infra-mammary incision should have the resultant scar in the infra-mammary fold itself - its basically invisible in that position. Check out my before/after photos and see what you think. Most PS do not perform trans-ax breast augmentation because of the implant malposition and capsular contracture issues associated with this procedure.
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February 8, 2022
Answer: In the right hands transaxillary is a fantastic approach. I know sometimes this forum can be so confusing but there are so many different approaches. I’m going to give you the exact opposite of Dr. Young. I have been doing the transax endoscopic approach for 20 years and would not continue to do so if there were the problems mentioned. Let me give you the advantages !1. I believe there is more discomfort for the first 2 to 3 days doing your hair but that is about it. The majority of your discomfort comes from the implant being under your muscle. Within five or six days patients are back doing what they want to do. 2. The scar in most cases is imperceptible. I hide it in a small crease in the under arm and it works great. I have seen horrible scars with an M for memory approach that are visible when the swimsuit rides up but anyone can have a bad scar.3. Many revisions can still be done through the under arm. I can add saline to an implant, adjust a pocket lower, fix mild capsular contracture, remove a ruptured implant and exchange it, exchange silicone or saline and I can insert up to 550 mL through the under arm (I’ve done 600 mL but it was a struggle!) 4. It is true that if the camera is not used, transaxillary does have a tendency for implants to ride high and wide. But using the camera changes all of that. 5. I like the incision being far away from the implant. With inframammary I’m always nervous if there is a wound infection that the implant is sitting right there.6. I do not see an increased incidence of loss of sensation of the nipple. In fact most patients get a little hypersensitive for several months and then return to normal. I also do not see a higher incidence of capsular contracture. I do have my patience massage and I use the Keller funnel. 7. The operative time is very short usually wheels in wheels out around one hour. 8. I believe there is a lower risk of bottoming out because the supportive tissues under the breast are not disturbed as they might be with under the breast incisions 9. Remember the three main incisions used are all acceptable and it really depends on the patient and Dr. comfort but again after 20 years I love it and so did my patients.
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February 8, 2022
Answer: In the right hands transaxillary is a fantastic approach. I know sometimes this forum can be so confusing but there are so many different approaches. I’m going to give you the exact opposite of Dr. Young. I have been doing the transax endoscopic approach for 20 years and would not continue to do so if there were the problems mentioned. Let me give you the advantages !1. I believe there is more discomfort for the first 2 to 3 days doing your hair but that is about it. The majority of your discomfort comes from the implant being under your muscle. Within five or six days patients are back doing what they want to do. 2. The scar in most cases is imperceptible. I hide it in a small crease in the under arm and it works great. I have seen horrible scars with an M for memory approach that are visible when the swimsuit rides up but anyone can have a bad scar.3. Many revisions can still be done through the under arm. I can add saline to an implant, adjust a pocket lower, fix mild capsular contracture, remove a ruptured implant and exchange it, exchange silicone or saline and I can insert up to 550 mL through the under arm (I’ve done 600 mL but it was a struggle!) 4. It is true that if the camera is not used, transaxillary does have a tendency for implants to ride high and wide. But using the camera changes all of that. 5. I like the incision being far away from the implant. With inframammary I’m always nervous if there is a wound infection that the implant is sitting right there.6. I do not see an increased incidence of loss of sensation of the nipple. In fact most patients get a little hypersensitive for several months and then return to normal. I also do not see a higher incidence of capsular contracture. I do have my patience massage and I use the Keller funnel. 7. The operative time is very short usually wheels in wheels out around one hour. 8. I believe there is a lower risk of bottoming out because the supportive tissues under the breast are not disturbed as they might be with under the breast incisions 9. Remember the three main incisions used are all acceptable and it really depends on the patient and Dr. comfort but again after 20 years I love it and so did my patients.
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