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Articles

The Invisible Incision Breast Augmentation

Vincent C. Giampapa, M.D., F.A.C.S.

Transaxillary breast augmentation is a procedure which literally allows for an invisible augmentation of the breast by placing the incision within the armpit. This approach creates an extremely natural final breast augmentation result, but no incisions whatsoever visible on the breast themselves.

The axillary incisions have a number of advantages over the breast incision approaches that are utilized by the vast majority of plastic surgeons. Utilizing the axillary/armpit incision is the only approach, where no functional muscle or breast tissue is injured, cut or disturbed. The incisions through the skin are accomplished with a standard scalpel, but once this is accomplished, 1 fingertip dissection is all that is needed to arrive at the lateral border of the chest/pectoralis muscle and create a subpectoral plane. Utilizing blunt retractors and blunt dissectors, a subpectoral space is created without cutting or injuring the underlying pectoralis muscle proper. Because the plane of dissection is below the breast tissue and below the pectoralis muscle, no functional breast tissue is disturbed, nor is the future function of the breast interfered with as well. For these reasons, future breastfeeding, as well as ease of mammogram evaluations are unaffected. Furthermore, should the patient develop either a lump or bump or breast mass, placing the implant underneath the chest muscle/pectoralis muscle, allows the implant to act as a platform for what the potential mass can be evaluated and even biopsied or removed without the need for removal of the breast implant, which is frequently the case with implants placed above the muscles.

Future breast health is important to all women. With the use of the axillary incision, no incisions are placed on the breast as described. Those approaches that utilize breast incision, must allow for healing to occur in the skin plane, in the muscle plane, as well as to the breast tissue proper. Each one of these sites are potential areas for scarring and calcification, which may mimic potential lesions on mammograms in the future. For this reason, the axillary incision and approach is again, one of the most favorable ones.

The incidence of breast capsule, or hardening of the breast below the pectoralis muscle is also much less than above the pectoralis muscle and thought to be much less even with other submuscular approaches. This is because the actual cutting of the muscle is avoided and therefore potentially less bleeding is accomplished with the axillary incision approach where no muscle is needed to be cut at all.

The natural look that occurs postoperatively with the transaxillary approach is another very positive result with this approach as well. The transaxillary approach allows for elevation of the intermammary folds in the more mature or droopy breasts and also allows for a natural overall look without prominent fullness in the upper pole of the breast.

Over the last 24 years, this technique has been utilized by Dr. Giampapa with overall superb results in actual longterm follow-up.

For those patients who are extremely active in professional or semiprofessional sports women, this is the ideal approach for breast augmentation. Dr. Giampapa has utilized this approach on a number of national body building female champions, as well as fitness pageant champions over the years, who have constantly remarked and have comments regarding how natural their breasts look and feel.

The invisible breast augmentation truly is the axillary approach.


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