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Breast augmentation transaxillary: advantages and disadvantages
Astrauskas T.1, Urbonas T.2, Astrauskaite G.2
1 - Kaunas Medical University Clinics, 2 – Kaunas medical university
Every breast augmentation method has its own indications but usually surgeons choose that one which is the most predictable, atraumatic and gives the best results (natural appearance and fast recovery). Our aim was to find the advantages and disadvantages of breast augmentation using transaxillary incision and to compare it with periareolar and inframammary techniques.
Material and methods
199 patients underwent breast augmentation during the year 2006 – 2008 in Kaunas Plastic surgery center. The patients were divided into 3 groups: I – transaxillary incision (114 patients): 87 submuscular placement and 27 subfascial placement of an implant; II – periareolar incision (62): 37 submuscular and 26 subfascial placement of an implant; III – inframammary incision (23): 20 submuscular and 3 subfascial placement of an implant. The duration of the operation, hospital stays, extent of postoperative bleeding and postoperative complications of each method were evaluated and compared. 
The average duration of the operation (minutes) using transaxillary technique was 44.28, periareolar 99, inframammary 87.26. The average hospitalization time (hours) using transaxillary technique was 46.52, periareolar 60.75, inframammary 61. The mean postoperative blood loss was 43.26 ml a day in transaxillary group, in periareolar group – 63.27 ml, in inframammary group – 67.48 ml. There were 2 (1.7%) capsular contractures and 2 (1.7%) seromas in transaxillary group; 3 (4.8%) capsular contractures, 4 (6.4%) seromas and 3 (4.8%) haematomas in periareolar group; 2 (8.6%) capsular contractures, 3 (13.04%) seromas and 1 (4.3%) haematoma in inframammary group.
When the implant was placed trough transaxillary incision the shortest operation time was achieved. Patients spent least time in hospital using this technique as well. Postoperative bleeding is least extensive and the frequency of complications is the smallest using transaxillary incision (p<0.05).

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