Endoscopic transaxillary breast augmentation: Clinical evaluation of a series of 306 patients over a 9-year period

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Transaxillary breast augmentation was described in the early 1970s. While the traditional blind operation continues to be advocated, the use of endoscopic assistance has been gaining acceptance since its first presentation about 12 years ago. This clinical study presents a series of 306 consecutive patients, who underwent endoscopic transaxillary breast augmentation over a 9-year period between 1996 and 2005-the largest series reported to date for this procedure. An initial 4- to 5-cm incision was made high in the axilla. Dissection was carried out to create an adequate tunnel for insertion of the implant. A subglandular, subfascioglandular, or submusculofascial pocket, depending on the individual case, was developed with endoscopic assistance. Injections of methylene blue through the different anatomic planes proved useful in the dissection of the pocket at the inframammary fold. In our series of 306 patients, we were able to achieve a hidden scar without compromising the aesthetic result. Complications included 3 hematomas, 5 cases of capsular contracture, 1 case of postoperative infection, and a 6.2% reoperation rate to correct implant malposition. Endoscopic transaxillary breast augmentation makes it possible to treat the same deformities, with the same refinements, as the more traditional approaches. The absence of scar in the breast aesthetic unit explains patients' interest in this operation. The technique has withstood the test of time. It has been found to be safe, has a relatively easy learning curve, and produces consistent results.