Dr. Larry Schlesinger: Hi! I'm Larry Schlesinger, and I'm a board certified plastic surgeon from Honolulu, Hawaii. And the question of the day is, "why do I prefer the transaxillary approach to breast augmentation?"

I have been doing breast augmentations for over 30 years, and I find that the most unhappiness with breast augmentations has to do with the scar. Scars around the nipple when they're visible are a turn off to everybody. Scars underneath the breasts are rarely good, and the idea that nobody sees underneath the breast is not true because the massage therapist sees it, when you're changing in the gym people see it, and everybody knows you've had a breast augmentation.

This is a very personal thing between the patient and the plastic surgery, and the fewer people who can identify that one has breast augmentation, the better. My breast augmentations are all put through the armpit except on revisions. Rarely on a revision are you able to put breast implants in through the armpit . Sometimes we can, but usually not. But primary breast augmentations through the armpit are great and the reason is that breast augmentations through the armpit got through what's called Langer's Line. So those nice creases in the armpit are there and if you follow the creases, ultimately the scar looks like the crease.

Secondly, no one, not even your mother has ever intentionally looked in your armpits. That is why I put all my breast augmentations, whenever possible of course, through the armpit. And I've even had the interesting situation of one lady who had her arm pits removed because of excessive sweating and we were still able to put it through the armpit, and it wasn't visible. I'm Larry Schlesinger from Honolulu, Hawaii, board certified plastic surgeon. Thank you very much.

Using the Transaxillary Approach for Breast Implants Surgery

Dr. Larry Schlesinger explains how he uses the transaxillary approach (through armpit) when putting breast implants in. Some of the reasons include scarring and nipple sensation. He shares a before and after photo of this approach.