Axillary breast augmentation — also referred to as the transaxillary approach or underarm breast augmentation — is a technique for placing breast implants through an incision made in the fold of the armpit rather than on the breast itself. For patients who are particularly concerned about visible scarring on the breast, this approach is one of the options that may be discussed at a specialist consultation.
\n\nThis article provides a general educational overview of how the axillary approach works, what distinguishes it from other incision sites, and the questions that most commonly arise. Suitability for any surgical approach can only be assessed by a qualified surgeon following a personal examination.
\n\nIn axillary breast augmentation, the surgeon makes a small incision in the natural skin crease of the armpit. This incision provides access to the tissue planes that lead to the breast pocket — the space beneath or above the pectoral muscle where the implant will be placed. Because the incision is sited in the armpit, no cut is made on the breast itself: there is no incision at the base of the breast, and no incision around the areola.
\n\nMany surgeons performing this approach use endoscopic assistance — a small camera passed through the incision to visualise the surgical field — which allows precise dissection and implant positioning without requiring a larger opening. This is described in more detail in our guide to endoscopic axillary breast augmentation.
\n\nThe primary reason patients consider the axillary approach is the location of the resulting scar. The armpit crease tends to heal well in most patients, and the scar — when well-placed in the natural fold — can become relatively inconspicuous over time. For patients who are concerned about any visible trace of surgery on the breast when wearing certain clothing or swimwear, the absence of a breast scar is an important consideration.
\n\nAdditionally, because no incision is made through breast tissue, there is no disruption to mammary gland tissue or the ducts that pass through it. Whether this has practical relevance for a particular patient — for instance, in the context of future breastfeeding — is a question to raise explicitly at a consultation.
\n\nThe axillary approach is not universally applicable. Several anatomical and surgical factors influence whether it may be appropriate:
\n\nWhether the axillary approach is appropriate for a given patient requires a physical examination and a full discussion of surgical goals. The team at Chirurgia Plastica MD has specific experience with minimally invasive breast surgery techniques including the axillary approach, and can advise on whether it is relevant to your individual case.
\n\nThe axillary incision is placed in the skin crease of the armpit. In the weeks immediately following surgery, the scar will go through the same maturation process as any incision: it may appear pink or slightly raised initially. As healing progresses over the following months, most scars in this location become paler and flatter. The natural crease provides a degree of camouflage even in the earlier healing stages.
\n\nScar appearance is influenced by individual factors including skin type, genetics, and adherence to wound care guidance. More detailed information about how scarring develops after breast surgery is available in our article on scarring after breast surgery.
\n\nRecovery after axillary breast augmentation shares many features with recovery from other breast augmentation approaches — swelling, temporary discomfort, and activity restrictions in the weeks following surgery. Patients may notice some additional sensitivity or temporary restriction in raising the arm on the operated side during the early healing period. Most patients find this resolves as the incision heals.
\n\nA general overview of what breast augmentation recovery typically involves is available in our week-by-week breast augmentation recovery guide. The specific instructions provided by the surgical team for an axillary procedure may differ in some respects, and those instructions take precedence.
\n\nTo discuss whether axillary breast augmentation may be relevant to your situation, please request a consultation with the specialists at Chirurgia Plastica MD.
\n\nThe term \"scarless\" is used in some contexts to describe axillary breast augmentation. It is more accurate to say that the approach avoids a scar on the breast itself. An incision is still made — it is simply located in the armpit. \"Scarless\" is an oversimplification, though the resulting scar, when well-healed, may be less visible than a breast scar for some patients.
\n\nIn some revision scenarios the axillary approach can be used, but in others — particularly where direct access to the breast fold or pocket is needed — a different incision site may be necessary. This is a question to discuss in detail at a consultation if you are considering revision surgery.
\n\nThe surgical dissection passes near lymphatic structures in the armpit, and an experienced surgeon takes care to work in the correct tissue plane. Endoscopic guidance — which allows greater visualisation of the surgical field — is often used for this reason. The implications for any individual patient should be discussed with the surgical team.
\n\nThe inframammary approach — placing the incision in the fold beneath the breast — also tends to produce a scar that becomes relatively inconspicuous over time, sitting in a natural crease. The choice between the two approaches is influenced by implant selection, anatomy, and surgical goals rather than scar location alone. Your surgeon can explain the comparative considerations for your individual situation.
\n\n\n ","content_text":"Informational content only. This article is for general educational purposes and does not constitute medical advice. It cannot replace a consultation with a qualified plastic surgeon. Results and experiences vary between individuals.\n\nAxillary breast augmentation — also referred to as the transaxillary approach or underarm breast augmentation — is a technique for placing breast implants through an incision made in the fold of the armpit rather than on the breast itself. For patients who are particularly concerned about visible scarring on the breast, this approach is one of the options that may be discussed at a specialist consultation.\n\nThis article provides a general educational overview of how the axillary approach works, what distinguishes it from other incision sites, and the questions that most commonly arise. Suitability for any surgical approach can only be assessed by a qualified surgeon following a personal examination.\n\nHow does the axillary approach work?\n\nIn axillary breast augmentation, the surgeon makes a small incision in the natural skin crease of the armpit. This incision provides access to the tissue planes that lead to the breast pocket — the space beneath or above the pectoral muscle where the implant will be placed. Because the incision is sited in the armpit, no cut is made on the breast itself: there is no incision at the base of the breast, and no incision around the areola.\n\nMany surgeons performing this approach use endoscopic assistance — a small camera passed through the incision to visualise the surgical field — which allows precise dissection and implant positioning without requiring a larger opening. This is described in more detail in our guide to endoscopic axillary breast augmentation.\n\nWhy do some patients and surgeons choose this approach?\n\nThe primary reason patients consider the axillary approach is the location of the resulting scar. The armpit crease tends to heal well in most patients, and the scar — when well-placed in the natural fold — can become relatively inconspicuous over time. For patients who are concerned about any visible trace of surgery on the breast when wearing certain clothing or swimwear, the absence of a breast scar is an important consideration.\n\nAdditionally, because no incision is made through breast tissue, there is no disruption to mammary gland tissue or the ducts that pass through it. Whether this has practical relevance for a particular patient — for instance, in the context of future breastfeeding — is a question to raise explicitly at a consultation.\n\nIs the axillary approach suitable for all patients?\n\nThe axillary approach is not universally applicable. Several anatomical and surgical factors influence whether it may be appropriate:\n\n Implant size: Very large implants may be difficult to introduce through the smaller access point the axillary approach provides. There are practical limits to the size of device that can be safely delivered through this route, depending on implant type, profile, and patient anatomy.\n\n Implant type: Highly cohesive implants may not be compatible with the axillary approach, as they cannot be compressed to pass through a small incision. More responsive implant fillings may offer more flexibility in this regard.\n\n Surgical goals: Patients requiring significant pocket modification, breast lift, or correction of asymmetry may be better served by an approach that allows more direct access to the breast tissue and fold.\n\n Revision surgery: In some revision scenarios, the axillary approach may not provide sufficient access, and an alternative incision site may be required.\n\nWhether the axillary approach is appropriate for a given patient requires a physical examination and a full discussion of surgical goals. The team at Chirurgia Plastica MD has specific experience with minimally invasive breast surgery techniques including the axillary approach, and can advise on whether it is relevant to your individual case.\n\nWhat does the scar look like?\n\nThe axillary incision is placed in the skin crease of the armpit. In the weeks immediately following surgery, the scar will go through the same maturation process as any incision: it may appear pink or slightly raised initially. As healing progresses over the following months, most scars in this location become paler and flatter. The natural crease provides a degree of camouflage even in the earlier healing stages.\n\nScar appearance is influenced by individual factors including skin type, genetics, and adherence to wound care guidance. More detailed information about how scarring develops after breast surgery is available in our article on scarring after breast surgery.\n\nWhat does recovery involve?\n\nRecovery after axillary breast augmentation shares many features with recovery from other breast augmentation approaches — swelling, temporary discomfort, and activity restrictions in the weeks following surgery. Patients may notice some additional sensitivity or temporary restriction in raising the arm on the operated side during the early healing period. Most patients find this resolves as the incision heals.\n\nA general overview of what breast augmentation recovery typically involves is available in our week-by-week breast augmentation recovery guide. The specific instructions provided by the surgical team for an axillary procedure may differ in some respects, and those instructions take precedence.\n\nTo discuss whether axillary breast augmentation may be relevant to your situation, please request a consultation with the specialists at Chirurgia Plastica MD.\n\nFrequently asked questions\n\nIs \"scarless breast augmentation\" an accurate description of the axillary approach?\n\nThe term \"scarless\" is used in some contexts to describe axillary breast augmentation. It is more accurate to say that the approach avoids a scar on the breast itself. An incision is still made — it is simply located in the armpit. \"Scarless\" is an oversimplification, though the resulting scar, when well-healed, may be less visible than a breast scar for some patients.\n\nCan the axillary approach be used for breast revision surgery?\n\nIn some revision scenarios the axillary approach can be used, but in others — particularly where direct access to the breast fold or pocket is needed — a different incision site may be necessary. This is a question to discuss in detail at a consultation if you are considering revision surgery.\n\nDoes the axillary approach affect lymph nodes?\n\nThe surgical dissection passes near lymphatic structures in the armpit, and an experienced surgeon takes care to work in the correct tissue plane. Endoscopic guidance — which allows greater visualisation of the surgical field — is often used for this reason. The implications for any individual patient should be discussed with the surgical team.\n\nHow does the axillary approach compare with the inframammary approach for scarring?\n\nThe inframammary approach — placing the incision in the fold beneath the breast — also tends to produce a scar that becomes relatively inconspicuous over time, sitting in a natural crease. The choice between the two approaches is influenced by implant selection, anatomy, and surgical goals rather than scar location alone. Your surgeon can explain the comparative considerations for your individual situation.\n\nMedical content disclaimer\n\nThis article is intended for general educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. The information presented here reflects general knowledge about plastic and aesthetic surgery and does not apply to any individual's specific circumstances. Always consult a qualified plastic surgeon before making any decisions about surgical or non-surgical procedures. To discuss your individual situation, please request a consultation with the specialists at Chirurgia Plastica MD.","related_posts":[{"slug":"endoscopic-axillary-breast-augmentation-overview","url":"https://insights.chirurgiaplastica.md/blog/endoscopic-axillary-breast-augmentation-overview","api_url":"https://insights.chirurgiaplastica.md/api/blog/endoscopic-axillary-breast-augmentation-overview"},{"slug":"breast-augmentation-recovery-week-by-week","url":"https://insights.chirurgiaplastica.md/blog/breast-augmentation-recovery-week-by-week","api_url":"https://insights.chirurgiaplastica.md/api/blog/breast-augmentation-recovery-week-by-week"},{"slug":"motiva-ergonomix-implants-patient-guide","url":"https://insights.chirurgiaplastica.md/blog/motiva-ergonomix-implants-patient-guide","api_url":"https://insights.chirurgiaplastica.md/api/blog/motiva-ergonomix-implants-patient-guide"},{"slug":"scarring-after-breast-surgery","url":"https://insights.chirurgiaplastica.md/blog/scarring-after-breast-surgery","api_url":"https://insights.chirurgiaplastica.md/api/blog/scarring-after-breast-surgery"}],"related_services":[{"slug":"minimally-invasive-breast-surgery","url":"https://insights.chirurgiaplastica.md/services/minimally-invasive-breast-surgery"}]}