Trans-Axillary Breast Augmentation

Natural looking, scarless Breast Augmentation through the armpit.

The armpit approach to Breast Augmentation, known as the Trans-Axillary Breast Augmentation, is the favorite method for breast enlargement at the Toronto Cosmetic Surgery Institute. It is a technique that allows Dr. Jugenburg to precisely and beautifully position a breast implant under a woman’s chest muscle without causing much disturbance to her breast.

Once fully healed, the operative scars are essentially invisible in the armpit, undetectable to the naked eye. No other person will be able to see the scars, let alone realize that a breast implant was inserted through them. Trans-Axillary Breast Augmentation has all the positives: the implant is placed under the muscle, the resultant breast shape is precisely controlled – with natural, feminine contours, both saline and silicone breast implants can be used, and there is no scar left on the breast.

Benefits of Trans-Axillary Breast Augmentation

  1. No scar on or under the breast.
  2. Scar often blends into the armpit crease and is very hard to detect.
  3. Usually the least visible of augmentation scars.
  4. No muscle is cut, only natural tissue planes are opened up to insert the implant.
  5. No breast tissue is injured and there is therefore no possible effect on breastfeeding.
  6. Implants can be inserted under the chest muscle (sub-muscular or sub-pectoral).
  7. Lower risk of bottoming out ( unfavorable downward movement of implant )
  8. Lower risk of Capsular Contracture (undesirable implant hardening)
  9. Less visible implant rippling/wrinkling (further information is given here)
  10. Mammograms are easier to read ( the implant is not directly behind the breast tissue )
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Preparation for Trans-Axillary Breast Augmentation

Prior to having any breast enhancement procedure, each patient should follow our general pre-operative guide on preparing for Breast Augmentation surgery. Key points of preparation for the Trans-Axillary surgery are:

  1. Shave the armpit area on the morning of the surgery.
  2. Wash thoroughly with soap and water. Any soap will do, special antibacterial soaps are not necessary.
  3. After washing, do not apply any antiperspirant sticks or sprays.
  4. After washing, do not apply any lotions or creams on your body.
  5. Leave you skin clean and dry to minimize risk of infection during surgery.

Trans-Axillary Breast Augmentation:  Your Surgical Timeline

Arrival

On the day of your procedure, you will arrive 2 hours before the scheduled time of surgery. Upon arrival at the clinic, one of our nurses will check you in. She will go through a checklist to ensure that you are ready and safe to proceed.

  • You will change into our surgical robes.
  • When you are ready, Dr. Jugenburg will come in to see you.

Pre-Operative Preparation

  • Dr. Jugenburg will review the surgical plan with you to ensure you fully understand everything. Dr. Jugenburg will ask you to tell him what you are having done. This is not because he has forgotten, but because he wants to hear from you in your own words what it is that you are having done. This is standard preparation for cosmetic surgery to ensure you are fully aware of what you are doing and to remind us of any adjustments you need or want in addition to the routine breast enlargement. For example, if in addition to the breast enlargement you would like Dr. Jugenburg to also remove a mole from somewhere on your body at the time of surgery, this will give you the opportunity to remind Dr. Jugenburg to mark that mole for removal.
  • Dr. Jugenburg will draw on you to mark various important locations (because things look different when you are standing, as compared to lying down) and to plan the surgery.
  • You will be taken to the Operating Room where our nurses will lie you down on the operating table, apply a number of electronic sensors that will monitor you during surgery (e.g., blood pressure, heart rate and oxygen) and make sure you are comfortable.
  • Our Anesthetist will insert an intravenous line through which you will receive medication and general anesthesia. Next thing you know you will be falling asleep and when you wake up, it will all be over.

The Surgery

  • Dr. Jugenburg and his team will clean your armpit area and chest with a special antiseptic cleaning solution in order to create a sterile environment.
  • Dr. Jugenburg will place a small incision in the armpit area through which a tunnel is created under the chest muscle (pectoralis major) towards the space under the breast (the breast pocket).
  • The breast implant is taken out of it’s sterile packaging, washed with antiseptic solution, and then care fully inserted directly into the pocket under the chest muscle. A Keller Funnel, which is a special surgi cal instrument, is used to perform this step (known as the No-Touch Technique) and further minimize any risk of bacterial contamination.
  • Dr. Jugenburg will compare both sides to create best possible symmetry.
  • The incisions are then closed using absorbable sutures. Unlike some other surgeons, Dr. Jugenburg does not usually use surgical drains. The benefit of this is a quicker recovery and no need to have the drain removed at a later date.
  • The surgery is over; the Anesthetist will be asked to turn off the anesthetic gases and you will slowly start to wake up.
  • You now have beautiful new breasts!

Recovering After Your Surgery

  • Our Operating Room team will apply various bandages to you and a surgical bra to protect the surgical results.
  • You will be moved from the operating table onto the recovery room stretcher, and then transferred to the Recovery Room. You won’t remember the first few minutes until you are fully awake. It is not uncommon for patients to have no recollection of the first 15 – 30 minutes after their surgery.
  • Our experienced Recovery Room nurses will carefully monitor you while you wake up.
  • You will be able to leave when you have fully recovered. Most of our patients have pre-arranged to stay at the Fairmont Royal York Hotel for its convenience to our facility, avoiding the need to take a long ride home, and having the luxury of a beautiful room with room service for the post-operative recovery.

Morning After Surgery Follow-up

  • The following morning you will return to the clinic to be re-assessed. If staying in the Fairmont Royal York Hotel, you will not need to have pre-arranged transport to return to the clinic (you will not be allowed to drive yourself), but can instead simply take the elevator to our clinic.
  • Our nurses and Dr. Jugenburg will examine you, and change your bandages if necessary.
  • You will have a compression band applied over the top of your new breast implants, pushing them downward. You will be given instructions on breast implant massage. Breast implants and swelling tend to sit high on your chest initially after surgery. Through the use of this band and breast massage, you will slowly massage your new implants into their proper position. Our staff will also give you instructions on where you can get your own surgical bra(s), or alternatively, you can order them through our office.
  • You will be cleared to go home in your pre-arranged transport.

Your Breast Augmentation Consultation

Dr. Jugenburg is a highly experienced plastic surgeon who always takes the time to get to know his patients and their needs before committing to any kind of surgery. At your consultation, you will have the opportunity to meet with Dr. Jugenburg, and let him know about the look you want to achieve. The doctor will guide you through the whole breast augmentation process: from the preparations you will need to make, through to the surgical procedure and aftercare. You will have the opportunity to ask any questions and raise any concerns you might have with Dr. Jugenburg and his team of highly qualified and friendly healthcare professionals.

Meet Your Doctor, Dr. Martin Jugenburg

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