Asian Breast Augmentation using Armpit Incisions | Dr Sackelariou

Asian Breast Augmentation via the Armpit

Double Bay, Sydney & Hawthorn East, Melbourne
Sydney 1300 661 362    Melbourne 1300 264 811

Asian Breast Augmentation in Melbourne or Sydney

Transaxillary Implant Surgery for Breast Augmentation

Transaxillary Breast Augmentation Surgery involves Breast Implant insertion through an armpit area incision, sometimes using endoscopic equipment, to place the breast implants into the chest area without leaving a scar under the breast crease.

The scar from a  procedure is located in the armpit area, rather than the inframammary area under the breast crease. It is also called “Asian Breast Surgery” and is sometimes the preferred breast augmentation surgery method by individuals of Asian, Middle Eastern, African or Indian heritage as pigment-rich skin tones may be subject to higher tendencies of keloid scarring for some patients.

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Common Surgical approaches for Breast Implant Insertion for Breast Augmentation (Transaxillary Implants)

There are 2 commonly used incision approaches for breast implant insertion in Australia.

  • Under the breast crease in what’s known medically as the inframammary fold (most common method)
  • Under the armpit in the transaxillary area (less commonly performed, but often preferred for Asian breast augmentation patients)

The other methods once used – including the areola-nipple incision approach –  is rarely used today, due to risks to nipple functions and lower patient satisfaction ratings with results.

The most common Breast Implant Surgery approach for inserting breast implants is the under breast or “breast crease insertion method”.

For this breast augmentation technique, incisions are made along the inframammary fold. The breast implant is then inserted either by hand or via an insertion implement, such as via a Keller Funnel.

  • Scars are often hidden under the breast tissues after augmentation as the breast tissues gently fall over the crease area and cover the scar.
  • Bras and swimsuits also tend to cover scars, although not all types of garments or fabrics will readily cover a breast surgery scar in the inframammary fold.
  • Breast Augmentation scars, however, may be more visible during dynamic body movements, such as when the arms are raised OR when the patient is lying down.
  • Some patients also have limited lower-pole breast volume even after augmentation, and the breast crease scar may remain visible in all positions, meaning the scar will show.

But there is an OPTION for the ARMPIT breast implant procedure or TRANSAXILLARY Implants or Armpit Area Breast Augmentation Method, that may suit Asian Breast Surgery patients and other individuals with pigment-rich skin tones.

Patients with pigment-rich skin tones, such as individuals with Asian, Middle East or African heritage, may be more prone to developing raised, bumpy-looking scars even when the best possible suturing has been performed after breast augmentation.

If scars under the breasts are a concern for you, there’s a good method for breast augmentation that Asian breast implant surgery patients might want to consider – it’s the armpit incision or Transaxillary Breast Augmentation Technique.

An Armpit Incision can only be used ONCE for a primary Breast Augmentation procedure but it can be used for removal of implants for suitable patients.

  • The transaxillary incision location can only be used once for breast implant insertion, and some patients feel this is it’s primary drawback but prefer to use it for their first breast implant procedure.
  • There will be a scar, but it is often located in the natural creases in the skin of your armpit; meaning it’s not always overly visible to others especially when your arms are naturally by your side or not being raised overhead.
  • However, the armpit area breast implant scar might be visible when you raise your arms, or visible to a trained eye; but it all depends on how you scar.

Pros and Cons of Breast Implant Surgery using ARMPIT incisions (Transaxillary Method) – Asian Breast Surgery

There are PROS and CONS to using this method, which will be covered during a consultation to determine what specific implant approach is going to suit your surgery goals, implant size choice, skin health and physique the best.

  • The Armpit Breast Implant approach is often best for PRIMARY surgery (your first breast augmentation procedure to insert your first pair of breast implants).
  • Revisional surgery (removal and replacement of your implants) at a later stage may need to be performed using the inframammary incision line approach (under-breast crease technique).

For Revisions and breast implant removal or replacements, your scars will typically be in the inframammary area or periareolar area.

  • If Revisional Breast Surgery is required, including future breast implant removal or removal and replacement down the line, you will incur new scars.
  • For some patients, removal of breast implants can be performed using the armpit incision method; but secondary implant surgery – such as replacement of existing implants with new implants – needs to be performed using the breast crease method.

Transaxillary breast augmentation can be performed with or without an endoscope – and there are advantages to both.

The main drawbacks of the Armpit  Breast Implant/Breast Augmentation procedure are that it can be MORE CHALLENGING to perform AND that it can only be used for primary breast implant insertions.

The reason it is more complex and challenging to perform Transaxillary Breast Augmentation is that the Specialist Plastic Surgeon is:

(a) operating further away from the incision and from the breast area and

(b) having to create a surgical channel to move the implant into its position, without overly disturbing other tissues.


Other common medical descriptions for this surgery procedure (armpit area breast implant insertion channels) include:

  • transax breast augmentation
  • transaxillary breast augmentation (sometimes misspelled transaxillary)
  • endoscopic transaxillary breast implant insertion method
  • armpit breast augmentation
  • armpit scars after breast implant insertion through the transaxillary area

Risks of Armpit Incisions for Breast Implants for Augmentation Surgery (Breast Enlargement)

  • In addition to the surgical challenges involved in getting a great result from augmentation using an armpit incision, there are some added risks to this incision choice.
  • These risks include a potential for injury to the lymphatic system near the breasts, or nerve damage that can lead to numbness in one or both arms or hands.
  • Additionally, wound care is particularly important as underarm sweating and increased bacteria levels might increase infection risks at the insertion line area.

Achieving breast symmetry with the armpit incision procedure can also be a greater challenge, so it’s wise to choose a qualified, experienced Plastic Surgeon who has performed many of these procedures and is an expert at Armpit Incision insertion methods.

Sometimes the inframammary incision method will be your best option for breast augmentation surgery, such as IF you have very noticeable asymmetry or other reasons why a transaxillary method is not suitable for your condition.

If you’re wanting to explore your options for breast implants or the so-called ‘scarless breast augmentation method,’ which is NOT actually without scars – as they’ll just be in the armpit area vs the under breast crease – phone and ask for a confidential consultation to see if you’re a suitable candidate for this breast augmentation surgery option.

Some patients have tendencies to scar more visibly after plastic surgery, such as having skin that is prone to keloid scar formations.  For these patients, a special insertion method for Breast Implants – known as Transaxillary Breast Implant surgery or ARMPIT insertion method – may be a better option than a traditional breast crease incision approach.

asian-breast-implants-armpit- transaxillary breast implant methodWhat’s the Difference between Transaxillary Breast Surgery and traditional Breast Implant Surgery?

Transaxillary Breast Augmentation vs Inframmary Incision Methods

Some skin types scar more easily and visibly than others. One form of scarring that tends to stand out more than others is keloid scarring. It’s an extreme form of scar formation that leads to raised, crooked, large or wide scars that become quite noticeable.

Scars after breast augmentation surgery

Most post-operation scars after breast implant surgery are relatively small. They typically remain hidden by placing incisions under the breast crease. As a result, the breast tissues cover them when the patient is standing.

But some people will have more prominent scars after Breast Augmentation procedures. Asian patients may be of higher risk for Keloid scars.

Although it occurs relatively infrequently, some people will have very visible scars after having breast augmentation surgery. This may relate to:

  • actions such as exercising too soon after your procedure
  • complications such as an incision line infections
  • genetics such as a tendency to develop elevated, crooked, raised or angry-looking scars. These remain that way even after time has passed. However, if you have an angry-looking scar, be sure you check to be sure it’s not an infection.

Ask your Plastic Surgeon, Dr Richard Sackelariou, for his advice on managing your scar risks after having breast augmentation surgery.

  • For example, it’s best to avoid sun exposure on fresh surgery scars for at least 12 months. This allows the scar to mature (a mature scar has settled in colour, depth or texture).
  • Sun exposure or early engagement in strenuous activities such as lifting and exercising, can increase your chances of having a poor scar result.

Surgery complications including wound healing infections, genetic tendencies or premature activities and sun exposure. These may lead you to have a more visible, wider-looking or elevated, crooked scar.

  • Be sure you do NOT smoke before or after breast implant surgery.
  • Smoking greatly increases your risks of complications including poor skin healing responses that lead to more visible scars.

Melanin or skin pigment impacts scar tendencies. Melanin is higher in people of Asian descent.

  • Pigment levels tend to be higher in people of Asian heritage than other less-melanin rich skin types such as Caucasian.
  • People who have higher melanin are usually a Type III or IV or higher on the Fitzpatrick skin tone scale.
  • They are also known to be more likely to get Keloid scars.

Special Asian Breast Augmentation Surgery Techniques for Asian Patients: The Armpit Incisions

Not all Asians or melanin-rich skin types are prone to Keloid scar development. However some people are, so if you’re having breast augmentation, it’s something to consider. And one potential solution is the armpit or transaxillary incision breast augmentation technique for breast implant placement.

  • Keloid scars are a type of scarring where fibrous tissue grows excessively to protect the wound. As a result large, hard but smooth growths occur.
  • These are often larger than the original incision line or wound.
  • They can range in texture and in tone.
  • Scars may be extremely dark compared to surrounding skin to lighter than surrounding skin in colour.

Keloid scars below the breasts after having breast implants can lead the breast area to look less attractive. So scar formations are a particular concern for many Asian breast surgery patients.
Hence, the Asian Breast Surgery option of a transaxillary incision method (through the armpit area breast implant insertion techniques) is worth exploring as an option. Dr Sackelariou specialises in this advanced and complex breast enlargement surgical technique.

Keloid scars after breast procedures occur more commonly in individuals who have Asian, Pacific Island, Mediterranean, Middle Eastern, Indian and Fijian heritage.

If you’re concerned about the scars you’ll have after getting breast implants, phone to arrange an appointment today.

However, keloid scars are also not uncommon in Caucasians and in individuals with poor wound healing responses.

  • By the age of 25 to 30 you’ll probably have an idea of your normal scar formation tendencies
  • However, keloid scars can sometimes form unexpectedly, even months after surgery, with no indications you were prone to developing them.

What can be done to prevent highly visible Keloid scars for Asian women who want Breast Surgery?

  • Not all Asian patients are at risk of developing keloid scars.
  • If you have Melanin rich skin, your surgeon will need to assess your risks of very visible or raised scars.
  • For Asian patients wishing to continue with Breast Surgery, the armpit incision method has become increasingly popular for some women.
  • Officially, it’s known as the Transaxillary Breast Augmentation method.

Asian Breast Surgery – the Transaxillary method of armpit area incisions – is only available for a primary breast surgery.

That means it’s available for some patients for their first-time breast procedure vs a revision or removal/replacement.

Secondary augmentation surgery or breast implant removals/replacements, and other corrective surgeries of the breast area, will require under-breast crease incision(s).

While it cannot be used for revision surgery or breast implant removal/replacement, the “TA Breast Augmentation” method remains one of the best options available to patients who want breast implants, but who are prone to keloid scars. It can help minimise the appearance of Breast Augmentation scarring on the front of the body.

You’ll still have a scar but it will be under the armpit. This potentially hides it in the armpit skin folds rather than beneath the breast on the front of your body.

  • Your surgeon makes an incision along the armpit area.
  • He takes care to avoid the lymphatics under the armpits.
  • The surgeon inserts the implant through the transaxillary/armpit area incision.
  • Your surgeon places the implant either under or over the pectoral muscle in the chest area.
  • Saline and silicone implants are available for this surgery, depending on the desired results of the patient.

Trans-Axillary Incisions aren’t widely known as many surgeons believe it’s impossible to get good results from implants inserted through the armpit.

However, skilled and dedicated surgeons like Dr. Sackelariou have years of experience in this complicated surgery. This style of surgery remains the best and most attractive option for Asian Breast Augmentation surgery.

It is important to know that Trans-Axilliary incisions can only be used once for Breast Augmentation Surgery.

Some Asian Breast Augmentation surgery patients may feel this is a drawback. Especially if they choose to have further procedures formed later in life. For other procedures, including implant removal/replacement, you will have to use inframmary or periareolar incisions.



About Dr Richard Sackelariou Plastic Surgeon

Dr Richard Sackelariou Plastic Surgeon Facial Surgery expert

Dr Richard Sackelariou MBBS FRACS(Plas) is a Specialist Plastic, Cosmetic and Reconstructive  Surgeon in Melbourne, Victoria and Sydney, Australia.

He is a highly sought-after Plastic Surgeon for precision procedures like nose reshaping, tummy tucks, breast surgery including transaxillary incision methods, implant removal/replacement and Breast Lift procedures,

He is particularly known for his signature surgeries – neck lift, facelift and eyelid rejuvenation procedures. He also performs expert cosmetic injections for facial rejuvenation.

Patient’s love his caring manner, his dedication to excellence and his extensive expertise in surgical planning for a natural-looking, harmonious result.

Next Steps – Book a Consultation with Dr Sackelariou

Best Plastic Surgeon in Sydney Botox Top Plastic Surgeon Melbourne

If you are considering reconstructive plastic or cosmetic surgery then Dr Richard is the specialist plastic surgeon for you. Dr Sackelariou can assist you in achieving your desired image, helping restore you to a more youthful or confident self.


  • A Referral from your GP or from your specialist is helpful but NOT essential – you can have a cosmetic consultation without a GP Referral although no Medicare rebates are claimable without one.
  • You can schedule a confidential consultation with your selected Specialist Surgeon by paying the $300 consult fee in advance.
  • Email us below or Call to arrange your surgeon consultation appointment


  • Bring a friend or relative to help discuss the information and your choices
  • Take lots of notes and read the documents provided thoroughly
  • You may need to undress for a physical exam so wear simple clothes


If you would like to know more about how Dr Richard can help you, please contact us today.

Phone Melbourne 1300 264 811 or Sydney 1300 661 362  to enquire or request a consultation.

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  • 759 Burwood Road, Hawthorn East, Victoria 3123