How is Breast Augmentation Performed Using a Transaxillary Incision?

Transaxiliary incision for Breast AugmentationWhen performing breast augmentation surgery, there are a number of incision options that can be used to insert and place implants, including the periareolar incision, the inframammary incision, and the transaxillary incision. As I discussed in my previous blog post, I prefer to utilize the transaxillary incision due to its decreased risk of bacterial contamination, lower occurrence of capsular contracture, reduced chance of affecting nipple sensation, very inconspicuous scar located off the breast, and a variety of other distinct benefits.

To perform breast augmentation with this approach, a small incision is made in the highest natural crease of the armpit. The length of this incision will depend on the type of implant being placed. For example, saline implants can generally be placed through a 3 cm incision whereas traditional silicone implants typically necessitate an incision approximately 4.5 cm in length. I have placed implants of all sizes utilizing a transaxillary incision, and I have even used it to place textured gummy bear implants as well.

Once inserted through the transaxillary incision, breast implants can be positioned either above or below the chest muscle. Despite this flexibility, I place virtually all breast implants under the muscle due to the various advantages of submuscular positioning. After the implant is positioned properly, the incision will be closed via surgical sutures.

Ultimately, the transaxillary incision heals so nicely that it’s often hard to distinguish the scar from a natural crease in the armpit.

Dan Mills, MD, FACS

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