The Plastic Surgery Channel

Breast Augmentation Without a Visible Scar

“One of the biggest advantages to this type of breast augmentation is there’s no scar on the breast.” —Robert Burk, MD

Board certified plastic surgeon Dr. Robert Burk from Jacksonville, Florida is talking about transaxillary breast augmentation. The transaxillary approach, also known as the underarm approach is where surgeons make the breast implant incision under the arm and use a telescope and television camera to go underneath the arm to make a pocket for the breast implant. To some patients that’s very important says Dr. Burk, “we try to make the breast look better and if we can do that without a scar, I think that’s an advantage.”

In 2007 the Food and Drug re-released the use of silicone implants, and in 2008 the FDA gave limited approval to gel implants. Burk says surgeons began seeing more and more women wanting the silicone gel because of their natural look and feel. “The problem was, unlike saline, silicone implants are filled prior to placing them in the body making the transaxillary approach more difficult because of the size of the implant,” says Burk.

The Keller Funnel

“With the use of the Keller Funnel it allows us to keep the tunnel fairly small and narrow, similar to what we use with the saline implant,” explains Burk. The Keller Funnel is a disposable, cone shaped, FDA approved device. The funnel allows the implant to slide through the cone and directly into the women’s breast pocket. “The Keller Funnel has allowed us to use the transaxillary approach or underarm approach with silicone gel implants more easily.  Before the use of the Keller Funnel one of the biggest limitations was the size of the implant. Traditionally we had to stay with relatively small implants when using silicone through the underarm approach. Using the funnel we can use much larger implants if that’s what the patient wants,” says Burk.

Advantages of Transaxillary Breast Augmentation

One of the biggest advantages with the transaxillary approach is the scar itself. Burk says, “The scar in the underarm area heals very nicely. We hide the scar in one of the wrinkles at the top of the underarm so it’s almost virtually invisible once it heals.”

Transaxillary Patient Recovery

Burk says the recovery, the complication rate, and any pain or discomfort is all the same. “It’s not really the incision that gives the patient discomfort; it’s the stretching of the breast tissue in the chest muscle. It really comes down to where does the patient want the scar? I like to let the patient decide where the incision is going to be, whether it’s under the arm, around the nipple, or under the breast. All of these scars can heal very nicely, but often times the patient wants something that doesn’t create a scar on the breast itself.”