Solving problems before they occur: Making transaxillary breast augmentation work for you

Transaxillary breast augmentation entails dissection of an implant pocket from a transverse skin incision in the hair-bearing region of the axilla. This inconspicuous incision is made possible, in part, due to the application of surgical endoscopes in cosmetic breast surgery. Avoiding problems with the transaxillary approach center on appropriate patient selection. Typical problems of breast augmentation are handled in similar fashion to other approach. Techniques and approaches utilizing surgical endoscopy to optimize visualization while minimizing scarring continue to evolve. As such, the key to avoiding complications with transaxillary breast augmentation is understanding the core principles of surgical endoscopy. Below we detail the concepts involved in the transaxillary approach to the breast using a surgical endoscope, which include optical cavity, support systems, illumination equipment, imaging technology, incision planning, and basic technical considerations. Addressing common complications such as pocket over-dissection or under-dissection will be discussed.