Axillary Breast Augmentation
Hidden, Underarm Breast Augmentation Scar
If you desire beautiful breasts, but are concerned about the scars created by the traditional methods of breast augmentation, an axillary endoscopic breast augmentation is a wonderful choice.
With axillary breast augmentation, an approximately 1.5-inch incision is made in the most hidden and hollow area of the underarm. The incision is placed in a skin crease, so that the scar is usually well hidden and hard to find after healing has occurred. A small tunnel is then made to the border of the pectoralis major muscle. The tunnel is continued under the pectoralis major to allow dissection of a sub-pectoral “pocket” for placement of the implant.
Axillary Breast Augmentation Techniques
There are two basic technical approaches to this operation. The older method is a “blunt” and “blind” technique where blunt instruments are used to create the sub-pectoral pocket, with no visualization of the surgery to check for important landmarks or to ensure there is no significant bleeding. This technique is not used by Dr. Connall.
Axillary Breast Augmentation
Though axillary breast augmentation surgery is widely accepted by many surgeons, it is the least commonly used breast augmentation technique. In Portland and, indeed, throughout Oregon and Washington, the axillary endoscopic breast augmentation technique is performed routinely by only a few surgeons.
The limited availability of the axillary breast augmentation technique in Oregon and Washington is due to surgeons’ preferences and not patient demand. We find that the axillary approach is the first choice for many women deciding on their breast augmentation incision. Given our specialization with axillary breast augmentation, women in the Portland, Oregon and Washington area seek us out to perform their augmentation surgery in this fashion.
Our Endoscopic Breast Augmentation Technique
Our surgeons’ technique (the endoscopic technique) is the most modern approach and uses an endoscope, a camera, TV monitor and fine surgical dissecting instruments. With endoscopic technique, they can see the entire surgical dissection and perform the surgery with fine cutting instruments. This brings complete precision and control to this surgery, with greater visualization and precision than are achieved with the traditional blind and blunt approaches to axillary breast augmentation. With axillary endoscopic breast augmentation, the anatomical landmarks are clearly seen and the space for the implant under the pectoralis muscle is opened precisely.
Breast Implant Placement
Round silicone and saline implants of any size can be placed through either a breast crease or axillary incision. The implant is first soaked in an antibiotic and saline solution and then gently placed in the pocket. If a saline implant is used, the implant is then filled. Silicone gel implants come pre-filled and sealed from the manufacturer, so they are inserted as their full size. With silicone implants a special implant insertion device, called a Keller Funnel, is typically used.
The size, symmetry and appropriateness of the results are assessed. If needed, the patient’s back will be raised as in the sitting position and the results will be assessed with the patient “sitting up” (while still under general anesthesia). The incisions are then closed with hidden, dissolvable sutures. Tissue glue or tape are then placed over the wounds. Finally, a post-surgical sports bra is placed.
Breast Augmentation Recovery
The recovery is very similar for all the approaches to breast augmentation. The post-surgical pain is similar for all approaches, as well. This is true because most the pain after breast augmentation is from the manipulation of the muscle and creation of the space for the implant. These maneuvers for creating the space for the breast implant are nearly identical with all approaches to breast augmentation. With the axillary incision, there is additional pain under the arm, of course. But this is not severe and does not affect the recovery much compared to the breast crease approach.
After breast augmentation, no drains, pain pumps, or chest wraps are used—you simply wear a post-op bra, which is like a sports bra. You go home an hour after surgery to rest. The day after surgery, you start feeling well and can shower and shampoo and blow-dry your hair. Most patients can return to most of their home and work activities within 5 days. You can perform some exercises three weeks after surgery and you can resume full activity six weeks after surgery. For more information about the surgical experience please see our sections on day of surgery and your recovery.
Axillary breast augmentation offers various advantages. Learn more about the axillary breast augmentation approach by contacting our office in Portland or scheduling a consultation at (503) 783-0544.