Subfascial Transaxillary Breast Augmentation Without Endoscopic Assistance: Technical Aspects and Outcome

Abstract

The TBA procedure without endoscopic assistance is a simple and reliable technique for breast augmentation. Most of the complications in this study were minor and predictable. They did not interfere with the aesthetic outcome nor the normal postoperative recovery. With TBA, success depends on patient selection as well as careful intra- and postoperative management.

Reoperative Transaxillary Breast Surgery: Using the Axillary Incision to Treat Augmentation-related Complications

“…Contrary to the suggestion of some authors [27], arm rest is of no use in avoiding implant displacement. We learned from correcting complications that superior displacement of implants is caused solely by unequal and insufficient elevation of the lower-pole pocket, usually caused by poor pocket visualization.…”

“…Some authors believe that this may be attributable to local inflammation of the cutaneous nerves. Others attributed the banding to possibly sclerosed lymphatic channels or to local thrombophlebitis [27]. To avoid this complication, we advocate early arm stretching followed by manual lymphatic drainage and ultrasound therapy twice a week for 1 month.…”

Transaxillary Subfascial Augmentation Mammaplasty with Anatomic Form-Stable Silicone Implants

“…In patients with a small areola or a poorly defined inframammary fold, TBA may be particularly advantageous. [10][11][12] Since the introduction of TBA techniques in clinical practice in 1973, 5 they have undergone significant modifications. The submuscular position was first introduced to provide optimal implant coverage; however, the drawbacks were breast asymmetry, implant displacement, and pain.…”

“…9,11,12,14 An alternative implant pocket is gaining popularity because of the better postoperative recovery it provides compared with submuscular approaches and because it avoids distortion when the pectoral muscle is contracted. 10,[22][23][24][25][26][27][28][29] Introduced in the 1990s, the subfascial technique is helpful for creating a support structure for the upper pole of the implant, which avoids inferior displacement and palpation of the implant edges. 12,22,23 In addition, with the advent of the subfascial technique, the potential benefits of TBA to patients, such as axillary incision and shorter recovery time, have become clearer.…”

“…[2][3][4] The transaxillary approach for breast augmentation (TBA) is a well-known procedure, and its main benefits are related to the absence of incisions on the breast and the ability to place the implant within the submuscular and subglandular plane (Solz H, personal communication, 2005). [5][6][7][8][9][10][11][12][13][14][15][16] Described initially for a submuscular pocket with blunt dissection, 5 the procedure is not without drawbacks, including implant displacement, muscular distortion, and postoperative pain. [17][18][19][20][21] Although TBA has been available for many years, critics have emphasized its limits in attaining precise positioning of the anatomic implant in the lower pole of the breast.…”