Endoscopic Transaxillary Breast Augmentation with Cohesive Gel Implant

ABSTRACT

The axillary approach for breast augmentation has held significant appeal to our patients. Its major advantage is the concealed scar at the apex of the axillary fossa. However, this route of access underwent legitimate criticism because of its reliance on blind dissection with the potential for associated secondary problems, such as implant ascension or distortion, implant misplacement, hematoma, or postoperative pain. However, with the use of an endoscopy combined with meticulous surgical technique, many of these problems have been eliminated, and this approach has gained widespread acceptance. The endoscopic approach to transaxillary breast augmentation offers better visualization, more controlled and precise dissection, better control of bleeding, and converting a blind procedure with blunt dissection into the current procedure, in which surgeons are in full control because the surgeons can visualize the field and dissect with precision. Furthermore, the type I dual plane dissection is possible because the surgeons can cut the origin of pectoralis major accurately. Endoscopic techniques have also improved the predictability of postoperative results and increased the safety of patient. In addition, the endoscopic technique can be used in various ways, such as subpectoral, subglandular, and subfascial dissection, as well as capsulotomy or supracapsular dissection in secondary operation cases.