The armpit incision for a breast enlargement, also known as the axillary approach, is fairly popular for a variety of reasons including the desire for some women not to have a scar situated directly on their breast. This preference can work as a double edged sword, though. If the ultimate scar that remains is not aesthetically ideal – inconspicuous – then its presence can be quite problematic and exposed for the world to see. This could then limit a woman’s options regarding certain clothing styles, for example, sleeveless tops.
My preference most of the time for the incision in breast augmentation is the inframammary one which lies along the crease at the bottom of the breast. It has numerous advantages over both the transaxillary and periareolar locations which can be discussed at the time of your consultation.
The patient whose underarm scar is shown in the photo, had her breast augmentation surgery performed elsewhere using the transaxillary incision. She developed thick hypertophric scars postoperatively which her plastic surgeon excised but they recurred. The problems that she faces now are scars which are prominent and visible when she wears sleeveless tops, gowns and bathing suits and which are occasionally associated with discomfort particularly when reaching.
Exposed keloid that resulted from a transaxillary incision in a breast augmentation. This already had been revised once by her original plastic surgeon.
If these same scars had been situated on her breasts, they would at least be covered by her clothes and not be so visible to others. As a result, she has to be very selective with the clothes that she wears including avoiding sleeveless tops which can make enduring Arizona summers with temperatures far in excess of 100 degrees Fahrenheit less tolerable.
A mastopexy is the surgical procedure that addresses droopy breasts by tightening the skin, recontouring the shape, and lifting the tissues to create a more youthful appearance. Without the insertion of breast implants, the results may be breasts that are more normal in shape than before but often smaller than expected by the individual which can lead to some disappointment.
When, then, should you consider implants be for your mastopexy? The answer to this is not very difficult most of the time. If you feel that your drooping breasts now are smaller than you would like them to ultimately be, then undergoing a breast augmentation along with the breast lift should allow you to achieve the desired enlarged size. Conversely, if your breasts presently are much larger than you want them to be, there would be no need for implants. Instead, a reduction in size by removing breast tissue would be appropriate.
It is somewhere in between these two “extremes” that determining whether or not to insert breast implants may not be entirely obvious. This decision is also based on the facts that a mastopexy involves the removal of at minimum a small amount of breast tissue and compacts the volume of what remains, most women desire more volume at the upper part of their breasts (a push-up look) and most women would prefer to be a little bigger than a little smaller.
I have found that a vast majority of my patients who undergo a mastopexy also have a concurrent breast augmentation. Even a relatively small breast implant may create a firmer, fuller, rejuvenated appearance with improved cleavage that can be quite alluring.
Breast augmentation has been one of the top two cosmetic procedures for years that women have chosen for themselves. Furthermore, around 94% of them were so satisfied with the procedure and its effects that they would make the same decision again. This is an incredibly high level of satisfaction for anything so there must be some significant underlying reasons for it. Clearly, this plastic surgery procedure should not be considered to be frivolous.
What are some of these reasons for its popularity? Having larger and more attractive breasts does provide women with a greater sense of confidence and assuredness, self-worth and an improved self image. In many ways they can further validate and enhance their femininity, attractiveness and allure all of which are important. Thus, the positive effects are a combination of physical, mental and emotional influences.
Most people nowadays seem to recognize the importance of the beneficial effects that breast enlargement has on women – and not from a self-serving perspective. I generally see husbands, boyfriends, family and friends being quite supportive for women considering this procedure – which is how it should be.
The following video is the heart felt testimony of a patient of mine that clearly expresses the positive impact that a breast augmentation has on a woman’s psyche, emotions and attitude and outlook:
Over more than twenty two years of practicing plastic surgery in the Scottsdale, Glendale and Phoenix metropolitan area, I have seen countless patients in consultation who have shared with me their extremely unpleasant and very painful experiences of having had their breast enlargement performed elsewhere with “twilight” anesthesia (awake but sedated). Many of them stated that they felt totally awake and were quite apprehensive throughout the procedure. Their final result might have been good but their negative experiences left an indelible mark.
My unequivocal recommendation for anesthesia for a breast enlargement and what I use for all of my patients is general anesthesia administered by an anesthesiologist, a doctor specializing in this area. You simply go to sleep, wake up and remember nothing until after you have been in the recovery room for a while. No anxiety and no unpleasant experiences. Period!
An overwhelming majority of board certified Plastic Surgeons use general anesthesia when performing breast augmentations as well as breast lifts and breast revision surgery and do so in fully accredited facilities such as outpatient centers and hospitals. Your safety and the pleasantness of the experience are of utmost importance.
You also should be aware that many of the physicians either marketing or using a “twilight” anesthetic for their patients’ breast augmentations are not board certified plastic surgeons. More often than not, they may be an obstetrician-gynecologist, general surgeon, an internist or even a family practitioner. Compounding this quality and safety issue even further, they may have the anesthesia delivered either by a nurse anesthetist or by a standard nurse or
other office personnel under their direction.
Do you really want to risk your health, safety, well-being and results to maybe save some money – at least in the very short term?