Common Questions about Transaxillary Breast Augmentation
Transaxillary breast augmentation is a surgery performed through the armpit with the assistance of an endoscope (video camera). The incision is small and hidden in the depths of the armpit and usually about an inch long. Because the procedure is done in a remote area away from the breast, an endoscope is used to assist… | Read More
Transaxillary breast augmentation is a surgery performed through the armpit with the assistance of an endoscope (video camera). The incision is small and hidden in the depths of the armpit and usually about an inch long. Because the procedure is done in a remote area away from the breast, an endoscope is used to assist in the dissection to help minimize bleeding. This helps create a precise clean pocket versus traditional transaxillary approaches, which is usually done blindly and bluntly. Without the use of an endoscope, the pocket is not created under direct visualization, which results in more bleeding and trauma to the soft tissues.
Frequently Asked Questions
1. What type of implants can be placed through the transaxillary breast augmentation?
The implants are usually placed under the muscle and both silicone and saline implants can be used. Any sized saline implant can be placed since they are filled at the time of surgery. On the other hand, silicone implants are all prefilled by the manufacturer and cannot be deflated and inflated. Therefore, silicone implants have a maximum volume that can be inserted through this tiny remote incision.
2. Why do patients choose the armpit incision for their breast augmentation surgery?
The most common reason to choose the armpit incision is to avoid a scar on the breast. Traditional approaches through the inframammary fold or around the nipple can be convenient and easier however leaves the patient with a scar on the breast. Although those incisions can be great for certain patients, smaller breasted patients tend to have a more visible scar with those approaches.
Dr. Hsu hides the scar in an existing skin crease high in the armpit and the scar normally heals well and is barely visible. An additional advantage is that even a poor scar is still hidden in the depths of the armpit and not visualized unless the patient raises her arms.
3. How does the armpit incision heal?
The armpit incision is about 1 inch in length. Normally, it is barely seen and blends in with the natural creases of the armpit. Many patients believe that it heals better than the periareolar or crease incision.
4. Is it more painful compared to the other incisions?
No. Pain with breast augmentation surgery varies from patient to patient but normally lasts 5 to 7 days and is well controlled with pain relief medications. The pain is usually related to the placement of the implants underneath the muscle whether this is done through the armpit, periareolar or crease incision. Thus, the armpit incision is no more painful than the other incisions.
5. Is there an increased risk of infection?
Even though there are some myths that the armpit incision results in more infection, this has not been found to be true. Studies have shown that the incidence of infection is very low and the same regardless of the incision used.
6. What care is required with the armpit incision?
The care is very simple. The armpit should be washed once a day and antibiotic ointment (Neosporin, Bacitracin, etc.) applied. The stitches dissolve on their own and usually take around 2-3 weeks to completely dissolve. Deodorant can be used in 7 days and shaving can be resumed in 14 days with care.
7. Will having the armpit incision affect me medically in any way?
No. When the armpit incision is made, none of the deeper structures of the armpit are disturbed. The structures of the armpit including the nerves and the lymph nodes are not affected.
8. What if the implants need to be adjusted?
Most small adjustments can be fixed with aggressive massaging. Increasing the size of the implant or replacing a leaking implant can usually be done through the original armpit incision. In more severe cases, such as capsular contracture, a separate incision on the breast may have to be placed in order to cut out the scar tissue.
9. How do the results look like?
Dr. Hsu uses mostly the armpit incision followed by the periareolar incision and then the crease or inframammary fold incision. Results with the armpit incision are excellent and patients are thrilled with the results since there is no visible scar on the breast itself.
10. Who can perform this procedure?
Because of the expertise and special training involved in transaxillary breast augmentation, not every plastic surgeon offers this approach. Your plastic surgeon should be able to perform breast augmentation surgery through a variety of incisions including the armpit, periareolar or crease incision to give you the most options. Dr. Hsu utilizes all three incision types and does not “cookie cut” every patient to one particular incision. He will offer his recommendations and work with you in regards to your expectations and budget.