*Updated on Wednesday, September 27, 2023
Axillary breast augmentation at our Chicago area practice—which is breast augmentation performed with an axillary or transaxillary incision—is a procedure that involves creating a small incision in the armpit area and then creating a tunnel for an empty implant to be inserted. Along with an inframammary incision (which is made along the crease below the breast) and a periareolar incision (which runs along the colored border around the nipple), an axillary incision is one of the three main incision sites.
What are the Advantages of Axillary Breast Augmentation?
The advantage of axillary breast augmentation is that the incision is placed in a location away from the breast so there is no visible scarring to the breast itself. Instead, the incision is placed in the armpit.
What Are the Disadvantages of Axillary Breast Augmentation?
The incision will not be detectable when your arms are by your sides, but will be visible if you bring your arms above your head. Remember this if you enjoy activities such as swimming, volleyball, or racquet sports around the Chicago area. The scar may also be visible in sleepless or strapless clothes. There may also be a higher likelihood of implant asymmetry in some cases.
My Approach to Axillary Augmentation
Some surgeons market axillary breast augmentation as if it is a new technique.
It is not.
Originally, the surgery was a “blind” operation. This means that the surgeon carried out the operation by making an incision under the arm and using long, somewhat gruesome instruments to create a space for the implant by pushing the instrument back and forth. The surgeon could not see the pocket he was creating. There are still some surgeons who do the operation this way. In my opinion this is a quick, but imprecise way to do the surgery.
The key to a beautiful result with breast augmentation surgery is precise control of the lower pole of the breast. I always felt I was sacrificing some of this precision when I carried out breast augmentation by a “blind” axillary approach.
The surgical endoscope has made axillary breast augmentation a much better procedure. With the endoscope and proper retractors, I am able to see what I am doing on a monitor as I create the pocket for the breast implant. This makes the operation more precise.
Which Implant Types Work Best for an Axillary Incision?
There is an advantage to using saline breast implants with the axillary approach. This is because empty saline breast implants are filled with saltwater after they have been passed through the incision and into the space I have created. These implants can be passed through a small incision with relative ease. The implant is rolled up and passed through the tunnel, then filled to a pre-determined amount. This is not the case with silicone gel breast implants since they are filled with silicone gel at the manufacturing facility. It is often possible to place silicone gel implants via an axillary approach, but the incision may have to be a little longer, depending on the size of the implant.
Please click here to see a short video that demonstrates the different types of breast implants.