What You Need to Know About Transaxillary Incisions

Reviewed by and by Michael Olding, MD, FACS

A transaxillary incision (transax or armpit incision) is one type of incision used in the placement of implants for breast augmentation.

The transaxillary incision is placed in the natural folds of the skin in the armpit.

Breast Area Anatomy Relative to the Transaxillary Incision

The breast comprises a complex group of tissues, including glandular, fatty, and fibrous tissues. The breast is positioned over the pectoral muscles of the chest wall and is attached to the chest wall by fibrous strands called Cooper's ligaments.

The breast extends as high as the collarbone, as far in the middle of the chest area as the breastbone, and as far toward to outside of the chest area as the armpit. When lying down, the armpit is immediately below the breast.

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How is the Transaxillary Incision Performed?

To perform the transaxillary incision, the incision is made in the natural folds of the armpit tissue, then a channel is created up to the breast. This procedure is sometimes performed with an endoscope, or a small tube with a surgical light and camera embedded in the end, to provide visibility through the channel. The implant is inserted and moved through the channel, then positioned and centered behind the nipple.

Advantages of the Transaxillary Incision

The biggest advantage with the transaxillary incision is that the scar is not on the breast. This incision can be used to place the implant in any of the three positions:

Consult a Surgeon

Each individual's situation is unique, and this incision may or may not be the best one for you. Be sure to discuss the advantages of each incision option with a board-certified plastic surgeon.

About the Reviewer of This Article

Michael Olding, MD, FACS, of Washington, D.C. is board-certified in plastic and reconstructive surgery by the American Board of Plastic Surgery and is a member of the American Society of Plastic Surgeons, the Northeastern Society of Plastic Surgery and the National Capital Society of Plastic Surgeons, where he was elected president. Dr. Olding specializes in cosmetic plastic surgery procedures and clinically related activities in cosmetic surgery, cosmetic facial surgery, breast augmentation and reduction, rhinoplasty, body contouring, liposuction and melanoma. He is also one of the area experts on soft-tissue fillers (Restylane, Sculptra and Botox). He received his doctorate in medicine from the University of Kentucky in 1980 and completed his internship at Cornell Medical Center. He completed his fellowship in plastic and reconstructive surgery at McGill University in Montreal. Dr. Olding maintains hospital staff privileges at George Washington University Medical Center, Sibley Hospital and Children's Hospital in Washington, D.C. More about Dr. Michael Olding