Transaxillary Breast Implant Incision: Pros and Cons

The transaxillary (or armpit) incision is one of 3 main incision sites you might choose when you opt to get breast implants.

breast implant incisions

If you opt for a transax incision site for the placement of your breast implants it will be because of specific reasons. How you decide that a transax incision is right for you will happen after a discussion with your chosen Board Certified surgeon.

Armpit Breast Implant Incision

A transax incision is made in the natural fold of the armpit tissue and the surgeon cuts (blunt dissection) from the armpit to the breast and the breast implant is placed behind the nipple in the pocket created.

Most women who chose to have a transax incision do so because they want to avoid visible scarring on the breasts.

Armpit incisions can be quite small and, if placed in the natural creases in your armpit (called 'Langer's lines') they can be relatively invisible.

breast implants through the armpits

The thing about a transax incision (and this is just FYI, not "don't do it") is it can be a bit of a double-edged sword.

A couple of things you would need to consider before you settle on this incision site are:

  • The type of breast implant you choose (silicone or saline) - the risk of bacteria contaminating a silicone implant through the armpit is higher (and thus the risk of capsular contracture is higher).

  • The position of the breast implant (under or over the muscle) - implants placed under the muscle through a transax incision require no dissection (incisions or cuts) of the muscle.

  • Risks are higher - surgery is usually done bluntly so the risk of bleeding is higher.

  • Complications are higher - transax incision carries the biggest risk of implant malposition (implants ending up where they shouldn't be - e.g. 'riding high' on your chest). That's because placing an implant through the armpit means the surgery happens a good bit away from where the incision is and is often done more by feel than by looking at what is being done from the inside.

  • You'll end up with more scars - if you experience a complication (or you want to change your implants) most surgeons will not re-use a transax incision site, so you'll still end up with scars on your breasts as new incision sites will need to be made.

  • Do you raise your arms a lot (seriously!) - every time you raise your arm people will see your scar. So, it may not be as invisible as you hope for.

Should I Choose an Armpit incision my breast implants?

This is why the decision to use a transaxillary incision can be challenging.

armpit incision for breast implants

If, after a thorough discussion with your chosen surgeon, you do opt for this incision ask whether your breast implant surgery will be performed using an endoscope (this is a surgical telescope with a light and camera at the end that allows a surgeon to see exactly what they are doing by viewing the surgery on a TV screen).

Using an endoscope for breast implants placed via the armpit makes the surgery more precise and decreases the chances of bleeding (because they can see and stop any bleeding) and therefore any subsequent complications (e.g. hematoma).

Be reassured that many excellent Board Certified plastic surgeons do breast augmentations through the armpit. If your chosen surgeon is experienced at placing breast implants through the armpit there's every chance you can get great results from your breast augmentation.

Transax aftercare

Following breast implant placement through the armpit you will need to be careful with your scars for at least a couple of weeks. If you wax your armpits, make your last wax at least a week before your surgery and do not shave your armpits until your wound has healed (you don't want to cut any stitches).

Check with your surgeon about deodorant after surgery too, as most will say you have to forgo it for the first couple of weeks.

The good news is that armpit incisions usually heal really quickly and often scars are hidden well in the natural creases of the skin. 

When you consult with a Board Certified plastic surgeon about breast augmentation they will assess your existing anatomy and listen to your augmentation goals to help you make the right decisions together. Like any decision in your boobie journey there are pros and cons if you opt for a transax incision..

The transaxillary approach is often misunderstood.  It is much more difficult and technically demanding than the more direct infra-mammary (underboob) or nipple incision sites. If you opt for a transax incision and you choose an experienced Board Certified plastic surgeon you can get great results from your breast augmentation. Just make any decisions together and be informed :)

Thoughts from Dr. Glenn Davis

Transaxillary surgery can be great but you might consider seeking out a surgeon who does this procedure specifically, with good results, hundreds of happy patients, and a lot of confidence in it.