Implants Placed through the Armpit — the Transaxillary Method

Many of our patients considering breast augmentation assume implants can only be placed through an incision made around the areola or along the breast crease on the underside of the breast. Many plastic surgeons push these incision locations on their patients, as they are the most straightforward and easy to do. However, especially with the incision on the breast crease, scarring can be problematic.

There is another option, called the transaxillary incision, which doesn’t leave any scarring on the breasts. This is because the incision site is in the armpit. Dr. Coleman has extensive experience with all incision locations used with breast augmentation, including the transaxillary incision.

In this blog, we’ll discuss the transaxillary method.

What is transaxillary breast augmentation?

When one of our patients chooses the transaxillary method, that means Dr. Coleman will place the implants through incisions made in the armpit. This incision location has both pluses and a few drawbacks.

The incision is made vertically in the armpit in the natural crease. Dr. Coleman then inserts an endoscope, a narrow fiber-optic camera through the incision. This provides visuals of the anatomical structures and guides Dr. Coleman throughout the procedure. At this point, either the unfilled saline implant or the silicone implant is inserted through the incision and placed into the pocket created to hold the implant. Saline implants are filled in place, and then are checked for size and position. The fill tube is then removed, and the implant automatically seals itself. The tube is withdrawn and the incision in the armpit closed. With silicone implants, Dr. Coleman checks position and symmetry and then closes the incision. Once the first breast is finished, he moves to the other side.

What are the advantages of this incision?

The main advantage of the transaxillary incision is that it does not create any scarring on the breasts. Because the incisions are made in both armpits and are made vertically in the natural crease, they become barely noticeable. This is quite a contrast to implants placed through the breast crease at the bottom of the breast, which creates a noticeable scar. This can be very important for patients with darker skin tones, as their scarring will likely be somewhat more visible going forward. Also, since Dr. Coleman doesn’t have to cut the chest muscle or any breast tissue, recovery from this incision location is easier for most patients.

What are the disadvantages of this incision?

In most cases, only saline or smaller-sized silicone implants can be placed through the armpit incision. But this is in line with Dr. Coleman’s goal of a natural result for his augmentation patients, avoiding placing overly large implants. Some surgeons avoid this method, as they can have difficulty with symmetry between the breasts. But Dr. Coleman has extensive experience with the transaxillary method and is completely comfortable with it. For many patients, the main drawback to the transaxillary incision is that it can only be used once. Since most implants will need to be replaced at least once (and probably more than that) over the patient’s lifetime that means future scarring will be made on the breast crease or around the areola.

During your consultation, Dr. Coleman will discuss your goals for your augmentation and together you will decide on your incision location. If you’re interested in breast augmentation, please give us a call and set up a consultation, (210) 251-4362.

Posted in: breast augmentation


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