31 May 2024

Transaxillary Breast Augmentation: Pros & Cons Explained

Understanding Transaxillary Augmentation


Transaxillary breast augmentation is a surgical method. It uses an incision in the armpit to enhance bust size in breast augmentations. This technique avoids scars on the breasts themselves. The surgeon inserts implants through this small cut.


This procedure suits those wanting no visible breast scars. Many choose it for aesthetic reasons. Scars remain hidden in the natural fold of the armpit, pectoral fascia, and inframammary creases.

Candidate Health

Candidates must be in good health. They should have realistic expectations about results. A thorough medical evaluation and consultation ensures they are fit for surgery.

Procedure Details

The surgery involves several steps:

  1. Anesthesia is administered.
  2. A small incision is made in the armpit.
  3. The surgeon creates a path to the breast area.
  4. Implants are placed and adjusted.
  5. The incision is closed with sutures.

Recovery takes time and care.

Recovery Process

Post-surgery, patients need rest and follow-up visits. Swelling and discomfort are common but temporary. Full recovery can take weeks.

Pros of Transaxillary Incision

Hidden Scars

Transaxillary breast augmentation offers the benefit of hidden scars. The incision is made in the armpit, using sharp electrocautery dissection through the pectoral fascia and pectoralis major, which means no visible scars on the breasts. This enhances the natural look of the augmentation. Patients often prefer this method because it avoids noticeable marks through blind technique and crease incision, ensuring proper dissection and hemostasis.

Wider Clothing Range

The location of the incision for breast augmentation allows for a wider range of clothing styles and accessibility to the pectoralis major during dissection. Sleeveless tops and swimsuits can be worn without concerns about visible scars from breast augmentation. This provides more freedom in fashion choices.

Small Scar Size

The scar in the armpit is typically small. Over time, these scars tend to fade, minimizing cosmetic concerns and damage from breast augmentation. Many patients report that their scars from breast augmentation become barely noticeable after healing.

Cons of Transaxillary Incision

Implant Limitations

Transaxillary breast augmentation often limits patients to saline implants. The incision method used in this approach for breast augmentation is typically too small for silicone implants. Silicone implants for breast augmentation require a larger opening due to their pre-filled nature. This limitation can be a significant drawback for those preferring silicone's more natural feel in breast augmentation.

Placement Challenges

Surgeons may face challenges with precise implant placement through the transaxillary approach, part of which involves dissection and navigating around the pectoralis major using an endoscope. The incision is made in the armpit, which can make navigating to the breast pocket part difficult due to the dissection of the pectoralis major with an endoscope. Achieving symmetry and correct positioning becomes harder compared to other methods, particularly in dissection mode of the pectoralis major part. This complexity can affect the final aesthetic outcome.

Additional Surgeries

There might be a need for additional surgeries if adjustments to implant position are required, involving endoscope use and pectoralis major dissection. Since the initial placement is more challenging, revisions involving dissection and the endoscope near the pectoralis major are sometimes necessary. These follow-up procedures add extra costs and recovery time for patients, including dissection. They also increase the overall risk associated with multiple surgeries, including dissection of the pectoralis major.

Exploring Alternative Incisions

Transumbilical Approach

The transumbilical approach uses an incision inside the belly button for dissection. This dissection method leaves no visible scars on the breast area. Surgeons use blunt dissection and sharp electrocautery dissection to create the implant pocket. An endoscope helps in guiding the dissection and placement of saline implants.

Candidates for this technique must have enough skin elasticity for proper implant dissection and positioning. However, it does not support silicone implants due to dissection and tubing work space limitations.

Periareolar Incision

A periareolar incision is made around the edge of the areola for dissection. This option works well for both saline and silicone implants during dissection. It offers good surgical control over the dissection and implant pocket creation.

This method results in a scar that blends with the natural border of the areola after dissection. However, there is a risk of infection, dissection, and changes in nipple sensation.

Inframammary Fold

The inframammary fold incision is placed under the breast, in the crease where it meets the chest wall, during dissection. This location provides excellent access for creating a precise implant pocket dissection.

Surgeons can use both blunt equipment and sharp tools to minimize bleeding and ensure hemostasis. The scar remains hidden under most clothing but may be visible when lying down or raising arms.

Scar Visibility Comparison

Each alternative incision affects scar visibility differently:

  • Transumbilical: No visible scars on breasts.
  • Periareolar: Scars blend with areola border.
  • Inframammary: Scars hidden under breast fold.

Choosing an incision depends on personal preferences and consultation with a qualified surgeon.

Implant Type Compatibility

Different incisions accommodate various implant types:

  • Transumbilical: Only saline implants.
  • Periareolar: Both saline and silicone.
  • Inframammary: Both saline and silicone.

Consult your surgeon to determine which implant type suits your goals best.

Surgical Control

Surgeons need good control during dissection to create a bloodless pocket:

  • Transumbilical: Limited control due to blind technique.
  • Periareolar: Good control over medial pocket creation.
  • Inframammary: Excellent control, ensuring precise placement.

Transaxillary vs Inframammary

Scar Visibility

Transaxillary incisions are hidden in the armpit. This makes scars less visible. Many women prefer this because scars are not on the breast.

Inframammary incisions are along the breast crease. These scars can be more noticeable, especially if wearing a bikini or low-cut top. However, they are often hidden under the natural fold of the breast.

Implant Suitability

Transaxillary incisions work well for saline implants. The surgeon inserts the empty implant and then fills it with saline once it's in place. Silicone implants can also be used but may require a larger incision.

Inframammary incisions offer more flexibility. Both saline and silicone implants fit through these incisions easily. This method allows for a wider range of implant types and sizes.

Surgeon Control

Surgeons have more control over implant placement with inframammary incisions. They can see the breast tissue directly, allowing for precise positioning of the implant under the pectoralis major muscle or above it.

Transaxillary incisions give less direct access to the breast area. Surgeons use specialized tools to create a pocket for the implant, which can make precise placement more challenging.

Choosing the Right Incision

Incision Types

There are several incision types for breast augmentation. Each has its pros and cons. Transaxillary incisions are made in the armpit. This leaves no scars on the breast itself. Another option is the inframammary crease incision, which is placed under the breast fold. This type allows direct access to the chest area.

Scarring Concerns

Scarring is a major concern for many patients. The transaxillary approach minimizes visible scars on the main body of the breast. However, it may leave a small scar in the armpit area. Inframammary incisions can result in a more noticeable scar but are often hidden beneath the breast.

Personal Priorities

Your personal priorities play a crucial role in choosing an incision type. If you prefer minimal visible scarring, transaxillary might be suitable. If easy access for implant placement is your priority, then inframammary could be better.

Consulting a Surgeon

Consulting with a skilled plastic surgeon is essential. They can explain each method's benefits and limitations clearly. Surgeons assess your anatomy and aesthetic goals to suggest the best option.

Anatomy Considerations

Individual anatomy significantly impacts incision choice. For instance, those with smaller breasts might benefit from an inframammary fold approach due to easier access to tissue planes.

Implant Type

The type of implant also affects incision choice. Silicone implants often require larger incisions compared to saline implants due to their pre-filled nature.

Tissue Impact

Different incision types affect tissue differently. The transaxillary method avoids cutting through major muscle groups like pectoral muscles, resulting in less trauma.

Age Factor

Age can influence healing time and scarring visibility. Younger patients generally heal faster and have less noticeable scars compared to older individuals.

Aesthetic Goals

Your aesthetic goals should align with your incision choice as well. If achieving a natural look is important, discuss this with your surgeon so they can recommend the most suitable technique.

Importance of Skilled Surgeon

Experience Matters

Choosing an experienced plastic surgeon is crucial for transaxillary breast augmentation. This procedure uses an incision in the armpit to place implants. It requires a high level of skill and precision. Surgeons with extensive experience can better navigate this complex method.

They understand the anatomy and potential complications. Their expertise ensures safer outcomes and more natural results.

Navigating Challenges

The transaxillary approach has unique challenges. Limited visibility and control are significant hurdles. A skilled surgeon can overcome these difficulties effectively.

They use specialized tools and techniques to improve visibility during surgery. Advanced instruments help them maneuver through tight spaces. Their knowledge reduces risks and enhances patient safety.

Thorough Consultation

A thorough consultation is vital before surgery. During this meeting, the surgeon explains the procedure in detail. They discuss realistic expectations and potential risks.

Patients should ask questions about the surgery's nuances. Understanding every aspect helps in making informed decisions. Clear communication between patient and surgeon builds trust.

Setting Realistic Expectations

Setting realistic expectations is essential for satisfaction. The surgeon evaluates the patient's body type and desired outcome. They provide honest feedback on what’s achievable.

This step prevents misunderstandings post-surgery. Patients must know that results vary based on individual factors.

Understanding Nuances

Understanding the nuances of transaxillary breast augmentation is important. This method avoids visible scars on the breast, which many patients prefer.

However, it might not be suitable for everyone. A skilled surgeon assesses if this technique fits the patient's needs. They explain all options available to ensure the best decision.

Recovery Expectations

Typical Timeline

Recovery from transaxillary breast augmentation involves several stages. Initial rest is crucial. Patients usually need to take it easy for the first week. Most return to normal activities within 4-6 weeks. Light activities can often resume after two weeks.

Post-Operative Care

Proper care post-surgery ensures a smooth recovery. Managing discomfort is essential. Pain medication and ice packs help reduce pain and swelling. Activity restrictions are also important. Avoid heavy lifting and strenuous exercise during the initial weeks.

Armpit Incision Healing

The armpit incision requires special attention. Scar care includes keeping the area clean and dry. Using scar creams or silicone sheets can aid in healing. Monitoring for complications like infection or unusual swelling is vital.

Adjustments Needed

Patients may need to adjust their daily routines temporarily. Sleeping positions might need changes to avoid pressure on the chest area. Wearing supportive bras as recommended by the surgeon helps maintain proper implant positioning.

Risk Awareness

Understanding potential risks is important for every patient. There might be risks of infection, bleeding, or implant displacement. Being aware of these risks allows patients to seek timely medical advice if needed.


Transaxillary breast augmentation offers a unique approach with distinct benefits and challenges. Understanding the pros and cons, along with comparing alternative incisions, helps you make an informed decision tailored to your needs.

Choosing the right incision and a skilled surgeon is crucial for optimal results. Recovery expectations should be clear to ensure a smooth process. Ready to take the next step? Consult with an expert surgeon today to explore your options and achieve your desired outcome.

Frequently Asked Questions

What is transaxillary breast augmentation?

Transaxillary breast augmentation involves inserting implants through an incision in the armpit. This method leaves no scars on the breasts.

What are the benefits of a transaxillary incision?

The main benefit is that it leaves no visible scars on the breasts. It also allows for precise implant placement.

Are there any downsides to transaxillary incisions?

Yes, this method can be technically challenging and may require specialized surgical skills. It may also have a longer recovery time.

How does transaxillary compare to inframammary incisions?

Transaxillary avoids breast scarring, while inframammary offers direct access to the implant site but leaves a scar under the breast fold.

Who is a good candidate for transaxillary breast augmentation?

Good candidates are those seeking minimal scarring and who have access to a skilled surgeon experienced in this technique.

Why is choosing a skilled surgeon important for transaxillary augmentation?

A skilled surgeon ensures precise placement and minimizes complications, which is crucial for this technically demanding procedure.

What should I expect during recovery from transaxillary augmentation?

Expect some swelling and discomfort in the armpit area. Most patients can return to normal activities within 1-2 weeks.