Transaxillary muscle-splitting breast augmentation: experience with 160 cases.

Background: Muscle-splitting breast augmentation, initially described by Baxter and later popularized by Khan, has proved to be an effective technique in terms of implant coverage, bypassing, and even solving of some issues associated with the dual-plane technique. A muscle-splitting breast augmentation technique recently has been used in combination with mastopexy. However, no reports have described muscle-splitting techniques accomplished by the transaxillary route.

Methods: A prospective study was conducted to evaluate the outcomes and complications of a novel approach to a specific breast augmentation technique. A total of 160 patients underwent bilateral transaxillary muscle-splitting breast augmentation between October 2007 and July 2010. All the patients were treated on an outpatient basis and received epidural anesthesia. Soft, round, textured, cohesive gel implants ranging in size from 200 to 350 ml were used.

Results: All the patients recovered quickly. To date, no infection, capsular contracture, rippling, double-bubble deformity, muscle contracture-associated deformities, or implant migration has occurred. Four patients (2.5%) experienced hematomas, all of which resolved before discharge. All the patients were discharged less than 24 h postoperatively and had an aesthetically natural result.

Conclusion: Transaxillary muscle-splitting breast augmentation, a novel approach to a technique that has been described previously, provides consistent, satisfactory results and good reproducibility. This new approach provides an excellent anatomic final appearance with no risk of displacement, rippling, double-bubble deformity, or contracture-associated deformities. Furthermore, this technique avoids any visible scars on the breast and features a low complication rate.