Transaxillary Breast Implants (Armpit Incision)
Transaxillary Breast Implants: Armpit Incisions for Breast Augmentation
When it comes to breast augmentation or breast enlargement surgeries using quality implants (Mentor or Motiva), there is an armpit incisions method known as the Transaxillary Implant Incision.
This method of implant insertion – where the incisions are made along the armpit areas – can help reduce visible scarring for people with skin tones prone to keloid scarring. It can be a preferred surgical option for placing breast implants into patients of Asian heritage or who have darker skin that shows surgical scars more readily than lighter skin.
Many people ask about scars after breast augmentation. Most incisions – and hence scars – will be hidden with incisions strategically located below the breast (in the inframammary crease) or – for some patients – in the armpit area (known as a Transaxillary Incision).
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Some skin types scar readily.
Everyone heals uniquely from surgery, but everyone scars.
Scars are evidence of your body’s natural healing processes after surgery. You cannot heal from an incision without a scar, but scars can be minimised in a number of different ways.
Scar minimisation methods include using Fraxel, hiding the scar in an area covered by clothing, creating ‘skinny’ scars, using medical-grade silicon gel strips (such as Mepiform or Strataderm products or silicone strips), or – for some skin types – hiding a breast implant scar in the armpit area instead of beneath the breast.
Everyone heals differently from surgery and everyone will have different scars. Many scars can be effectively hidden in the breast crease or underarm area (transaxillary or armpit area).
Whilst everyone will scar after an incision, the difference in your healing and scar formations will impact how much your scar(s) will show afterwards on your skin.
These include skin types with higher melanin concentrations (darker skin pigmentation) such as frequently seen in individuals from Middle Eastern, Southern Mediterranean, Pacific Islands and Asian-Pacific regions.
Scars and Tanning – Sun Exposure After Surgery
Plus, some skin types tan more readily than others, and scar tissue does not tend to respond to sun exposure in the same way as non-scar tissue, meaning that tanning and sun exposure can leave your scars more highly visible.
There are specific post-augmentation surgery protocols your Surgeon will advise you about to minimise the likelihood of very visible scars – avoiding sun exposure for several months after surgery may be part of your post-op recovery plan.
Breast Augmentation through the Armpit (Transaxillary Incisions Augmentation)
An ARMPIT INCISION (Transaxillary incision) is used by Dr Geoff Barnett for some skin types, in order to help minimise visible scars.
For skin types with higher pigmentation and a propensity to scar more readily – including a tendency towards keloid scars (raised scars) – different approaches to breast augmentation surgery can be quite helpful.
The gold standard approach for some darker skin types for Breast Enlargement Surgery with implants is to use a transaxillary incision. To use the Transaxillary Incision approach means that an incision – and implant entry point – will be created in your underarm (or armpit) area.
Quality brand breast implants – such as Mentor or Motiva implants – can be placed over the muscle, partially underneath the muscle, or completely behind the muscle/fascia with this type of incision.
There are both benefits and deterrents for using the Transaxillary breast implant approach.
Additionally, it is considered a more-complex augmentation surgery requiring the great finesse of a Plastic Surgeon with great experience in this procedure.
Dr Barnett uses a Transaxillary Incision approach for primary breast augmentation on suitable candidates, to help minimise surgical scars from breast enlargement surgery.
Why haven’t you heard much about the Armpit Incision approach to Breast Implants?
The transaxillary incision approach to breast augmentation is not as well known as the infra-mammary incision approach. It is certainly also not nearly as widely used, and only a very small percentage of implants are inserted through an armpit incision.
However, the trans-axillary incision insertion of implants can get great results in terms of scar minimisation for breast augmentation patients of Asian, African, Pacific Island, Maori, Philippines, Malaysian, Thailand and Indian heritage as well as other higher-pigmentation skin types.
The Transaxillary Incision Surgery Approach to Breast Surgery: A Great Alternative for Skin Prone to Raised Scars
Inserting breast implants through a transaxillary incision (armpit incision) is much more difficult and technically demanding than most other implant methods. The armpit incision approach requires more technical skill than a standard infra-mammary approach. That’s why it’s important to choose a Plastic Surgeon with extensive experience.
This is the primary reason that many Cosmetic Surgeons and some Plastic Surgeons think it is difficult or nearly impossible to get a great result from using the transaxillary insertion method.
But a skilled Surgeon can perform the Transaxillary Incision and Breast Implant Insertion in a successful way that minimises visible scars around the chest area.
It’s important, however, that the entry dissection through the armpit be done carefully and with high-precision planning.
That’s because the lymphatics that drain the breast area are near to the incision or implant-entry point.
Your Surgeon should avoid disrupting the function of your lymphatic nodes in the armpit area during your breast implant insertion surgery. To avoid the lymphatic nodules in the armpit area, your Surgeon must avoid traversing the surgical axilla (it usually means staying somewhat high in terms of incision areas). The risk here is that implants may end up riding ‘a bit higher’ than if you had them inserted from an inframammary incision. However, a great Surgeon can minimise this potential outcome using advanced surgical planning and precision incision skills.
Another risk is that the implant pocket and the entry point incision might be challenging to surgically align in this area. All breast implants sit in a customised ‘pocket’ your Surgeon creates with special surgical tools. The pocket is designed to place an implant either behind the breast muscle or in front of the breast muscle, or partially behind the muscle – this is known as dual-plane implant placement.
It can be challenging to get an accurate and well designed inferior pocket for your implants if your Surgeon is using the transaxillary incision insertion approach.
The Transaxillary Incision
A transaxillary incision is made in the armpit, placed along a natural fold of skin that is present in that area.
Once the armpit incision has been made, a channel to the breast is then created, and “pockets” (areas to hold your selected implants) are then made behind your breasts.
Saline or Silicone implants and Armpit Incision Approaches to Breast Augmentation
Both saline and silicone implants can be used in this surgical method for breast enlargement. Some Plastic Surgeons prefer saline implants for this approach, primarily as they are not pre-filled (whereas silicone implants are pre-filled with gel). A silicone implant is shown below.
Saline implants can be filled after placement
With saline breast implants, the implant shells can be inserted and the implants can be filled after they are in place.
This means the incision can remain somewhat minimal (or small). However, saline implants can occasionally deflate. If your saline implant became deflated, this might lead to additional surgery where your implant replacement incisions would need to be made in the breast area in the ‘under-breast’ skin crease.
Armpit Incisions for Breast Implants: Why do some people prefer Transaxillary Incisions?
Scar minimisation in the breast area is the primary reason some patients request transaxillary incision and implant placement methods.
With incisions under the arms, the fact that you’ve had a breast enlargement may be less noticeable to others. It can also potentially cause less interruptions to the mammary glands than inframmary or periareolar incisions; which may be of benefit for later breastfeeding – yet many women who have had inframmary or periareolar incisions for their implants by a skilled Plastic Surgeon have been able to breast feed afterwards.
An Armpit Incision can only be used ONCE for a primary Breast Augmentation procedure
The transaxillary incision location can only be used once, and some patients feel this is its primary drawback.
If Revisional Breast Surgery, future implant removal or eventual removal and replacement is needed down the line, you will incur new scars.
For Revisions and breast implant removal or replacements, your scars will typically be in the inframammary area or periareolar area.
Transaxillary breast augmentation can be performed with or without an endoscope – and there are advantages to both.
The main drawbacks of the procedure are that it can be more difficult to achieve the best placement of the breast implant because the Plastic Surgeon is (a) operating further away from the incision and from the breast area and (b) having to create a surgical channel to move the implant into its position, without overly disturbing other tissues.
Other common medical descriptions for this surgery procedure include:
- transax breast augmentation
- transaxillary breast augmentation
- armpit breast augmentation
Risks of Armpit Incisions for Breast Implants for Augmentation Surgery (Breast Enlargement)
In addition to the surgical challenges involved in getting a great result from augmentation using an armpit incision, there are some added risks to this incision choice.
These risks include the potential for injury to the lymphatic system near the breasts, or nerve damage that can lead to numbness in one or both arms or hands.
Achieving breast symmetry with the armpit incision procedure can also be a greater challenge.
So if you suffer from very noticeable asymmetry (uneven breasts) including breast sizes or shapes – with one side looking very different to the other side – then you might be better off having a breast enhancement surgery performed using a different incision method for your implants. Additionally, if a complication occurs during your primary breast augmentation surgery, and you need to have revision surgery, you could end up with multiple incisions (some under your armpit, some under your breast) – where if you start with surgery using an inframammary insertion point, the incisions for Revision surgery can typically be placed in the same place again for the revision.
Interested to learn more about Breast Augmentation using armpit incisions in Melbourne?
Your successful outcome is our highest priority.
Dr Barnett and his dedicated staff aim to ensure your consultation in his rooms is professional, relaxed and as well informed as possible. He is a highly skilled Plastic Surgeon with over 20 years of experience so you can relax knowing you’re choosing a very skilled Surgeon who has specialised in these procedures.