Breast augmentation: Axillary approach

Abstract

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. © 2009 Springer-Verlag.