Transaxillary Breast Implants - Dr Richard Sackelariou - Plastic Surgeon

Transaxillary Breast Implants

Double Bay, Sydney & Hawthorn East, Melbourne
Sydney (02) 9362-0676    Melbourne (03) 8849 1444

Transaxillary Breast Implants


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.

Transaxillary Breast Implant Surgery – Surgical Approaches and Suitable Candidates

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.

asian-breast-implants-armpit- transaxillary breast implant method

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 an 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 procedure 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.

Definition of 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 Transaxillary Breast Implant 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.


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.

Explore your Asian Breast Augmentation and Armpit Incision Options with Dr Richard Sackelariou, highly experienced Plastic Surgeon with consulting rooms in Double Bay.

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.

Phone in Melbourne on (03) 8849 1444 or Sydney on (02) 9362-0676

Dr Richard Sackelariou is a FRACS qualified Specialist Plastic Surgeon with offices in Melbourne and Sydney. He is highly respected by peers and patients for his expertise in breast surgery, body contouring, facial rejuvenation and cosmetic injections.

Got A Question?

Ask any questions you might have regarding a procedure and voice any concerns you may have.

Sydney: (02) 9362-0676
Melbourne: (03) 8849 1444


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Contact Details



  • 759 Burwood Road, Hawthorn East, Victoria 3123