What is the advantage of axillary approach for breast augmentation?

The breast augmentation axillary approach does not invade the breast tissues directly, going underneath instead. This means that you have a less chance of permanent numbness. In addition, the pectoralis muscle is not divided which gives a stronger support for the implant over time. Another advantage is that there is no scar left on the skin of the breast. Instead, the scar is located in the armpit in a high wrinkle, which is a much less noticeable location. Typically, the scar is smaller.

How much can my breasts be enlarged?

The degree of enlargement is based on the anatomy of the patient’s body more than any other factor. Saline-filled implants require placement underneath the muscle layer of the chest to achieve a natural result in most patients. The implant must be covered by the muscle layer, and this coverage determines the maximum volume of the implant. The width of the patient’s chest, as well as the locations of nerves in the chest and abdomen limit the maximum volume of an implant that can be used, because the total width of the implant must fit underneath the muscle without intruding into the nerve bundles, otherwise numbness of the breast and/or nipples would result. Your surgeon can help you determine the best size of implant for you at the time of your consultation.

Most of my patients desire a full, proportional look. They want something nice but not too obvious. I prefer to create nice looking breasts that fit a patient’s body well rather than very large breasts that are too large for the frame. In fact, I do not have any patients that have told me that I have made them too large.

Will I be able to breast feed?

Breast augmentation (under the muscle layer) should not affect your ability to breast feed. For sub-glandular augmentation (under the breast tissue, but over the muscle layer), like any other surgery which disturbs the breast tissue itself, there is a risk of losing the ability to breast feed. I do not perform subglandular (over muscle) primary augmentations.

Why did my breasts get small and droopy after pregnancy?

Breast get small and droopy after pregnancy due to a loss of volume. Often associated with drooping, is very common after pregnancy and is called post-partum breast involution. Volume loss with a small amount of sagging can be corrected with the breast augmentation surgery. For an excessive degree of sagging, a mastopexy or ‘breast lift’ may be the solution. I typically perform a minimal incision breast lift with augmentations. This means that the lift incision is only a circle around the areola. Severe breast drooping may require an additional incision.

I have heard about breast implant surgery going through the belly button. Can you do this?

This type of procedure is called a ‘trans-umbilical approach’. I have trained in this procedure and learned it from the surgeon who invented it. However, our malpractice carrier, the one with the most plastic surgeons, refuses to cover this procedure. They claim that the procedure is associated with much litigation. In addition, the implant manufacturers frown on this technique. I value the opinion of the largest plastic surgery malpractice company and implant manufacturer. It is probably not a good idea to have an augmentation with this technique.

What can you do to correct asymmetries or differences between the breasts?

Nearly everyone I have examined has some asymmetry in their breasts. Sometimes these differences are subtle and other times they are more pronounced. It can be a difference in size, height of the nipple, amount of drooping, height of the breast fold, contour of the ribs, height of the shoulder tips, etc. Many times we can attempt to correct or improve upon the asymmetries. This can be done by lowering a fold, place slightly more saline on one side, etc. Most of the time, there are subtle asymmetries before and after surgery.