Muscle-Splitting Transaxillary Revision Breast Augmentation—A Single Surgeon’s Experience

Well discussed in a previous article published by the senior author, primary transaxillary breast augmentation drawbacks include the need to correct complications arising from reuse of the axillary incision which the literature is sparse on. We here discuss a technique in patients who underwent a secondary transaxillary breast augmentation procedure.

This study aims to present a technique for transaxillary revision breast augmentation with conversion to a muscle-splitting plane which has the advantage of good upper and medial pole coverage and adequate lower pole expansion.

We performed a retrospective chart review of 41 women with previous silicone gel implants placed through a transaxillary incision who presented with rippling or a desire for larger implants (January 2016–July 2020). Inclusion criteria were age 18 years or older and having undergone breast augmentation surgery. Exclusion criteria were active smoking and body mass index (BMI) greater than 30 kg/m². At one year postoperatively patients were asked a “yes or no” question regarding satisfaction with the overall result and with the scar quality.

A total of 41 patients were included in this study; no patients were excluded. The patients’ age ranged from 32 to 47 years, the average being 38 years old. All participants were female. Mean BMI was 21.9 kg/m² and all patients had a pinch test <2cm. Indications for surgery included rippling (all patients) and a desire for larger implant size (n = 5). Size of new implants ranged from 325cc to 430cc; all were of a larger size than those used in the primary surgery. Operative time was on average 53 min. [4483 min.]. Mean follow-up was 13 months, ranging from 12 to 15 months. There was no additional cost related to operative time. Regarding patient satisfaction, 100% replied they were pleased with the overall results and scar quality. There were no major complications.

The transaxillary approach for muscle splitting breast augmentation revision surgery offers a safe and reproducible technique. Despite having a mean follow-up of only 13 months, we demonstrate a low rate of complication as well as high degree of patient satisfaction with no extra cost when compared to other techniques.

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