Breast Augmentation: Axillary Approach

  • George John Bitar


The main indication for a breast augmentation is hypomastia or breast asymmetry. The author discusses the preoperative consultation, the preoperative workup, the type of implants to use, and whether to do a mastopexy. The technique of breast augmentation using the axillary approach, postoperative care, and possible complications are described. The advantages of the axillary approach include a small and inconspicuous scar, the ability to insert the implant subpectorally with minimal muscle dissection, less time needed to perform the surgery, minimal bleeding, less trauma and scarring, less pain, less bruising, and a shorter recovery time with minimal complications. The milk ducts are not manipulated, so the risk of losing the ability to breastfeed after a breast implant with this approach is negligible. The breast tissue is not dissected, so there is no additional scarring that may affect mammogram readings. There is a lower probability of injuring the 4th intercostal nerve that supplies sensation to the nipple, so this approach has an extremely high probability of normal nipple sensation after the breast augmentation.


Breast Augmentation Breast Implant Capsular Contracture Silicone Implant Axillary Approach 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Momeni A, Padron NT, Fohn M, Bannasch H, Borges J, Ryu SM, Stark GB: Safety, complications, and satisfaction of patients undergoing submuscular breast augmentation via the inframammary and endoscopic transaxillary approach. Aesthetic Plast Surg 2005;29(6):558–564PubMedCrossRefGoogle Scholar
  2. Dowden R: Keeping the transumbilical breast augmentation safe. Plast Reconstr Surg. 2001;108(5):1389–1400, discussion1401–1408PubMedCrossRefGoogle Scholar
  3. Hendricks H: Complete submuscular breast augmentation: 650 cases managed using an alternative surgical technique. Aesthetic Plast Surg 2007;31(2):147–153 PubMedCrossRefGoogle Scholar
  4. Serra-Renom J, Garrido MF, Yoon T: Augmentation mammaplasty with anatomic soft, cohesive silicone implant using the transaxillary approach at subfascial level with endoscopic assistance. Plast Reconstr Surg 2005;116(2):640–645 PubMedCrossRefGoogle Scholar
  5. Handel N, Cordray T, Gutierrez J, Jensen JA: A long-term study of outcomes, complications, and patient satisfaction with breast implants. Plast Reconstr Surg 2006;117(3):757–67, discussion 768–772PubMedCrossRefGoogle Scholar
  6. Pittet B, Montandon D, Pittet D: Infection in breast implants. Lancet Infect Dis 2005;5(2):94–106PubMedGoogle Scholar
  7. U.S. Food and Drug Administration. Breast Implant Consumer Handbook 2004, accessed 30 May 2007. Google Scholar
  8. Troilius C: A ten-year evaluation following corrections of implant ptosis subsequent to transaxillary subpectoral breast augmentation. Plast Reconstr Surg 2004;114(6):1638–1641, discussion 1642–1643PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2009

Authors and Affiliations

  • George John Bitar
    • 1
  1. 1.Bitar Cosmetic Surgery Institute, Visiting Lecturer, Department of Plastic SurgeryUniversity of VirginiaManassasUSA

Personalised recommendations