Endoscopic Breast Augmentation

Endoscopic Breast Augmentation EndoscopicMobile

Endoscopic Breast Augmentation

At Wave Plastic Surgery

Breast augmentation remains the most popular cosmetic procedure in the US year after year. But it’s still often thought of as a heavily invasive procedure with a lengthy recovery.

However, thanks to medical advancements, that’s not the case anymore. Endoscopic breast augmentation is a technique that uses small, discrete incisions and has a shorter recovery period. It’s a great option that you may not have considered.  We’ll guide you through everything you need to know about the procedure.

What Is Endoscopic Breast Augmentation?

The word augmentation refers to “the process of making something greater in size”. There are many different options available for breast augmentation. But they all refer to plastic surgery to increase the size of the breast, most often through breast implants.

When breast augmentation first increased in popularity as a cosmetic procedure, many decades ago, surgical procedures were less sophisticated than they are now. In the traditional method, surgeons would insert silicone implants beneath the chest muscles or breast tissue.

To insert these implants, the surgeon would create an incision either around the nipple or within the crease beneath the breast. As you can imagine, these incisions were sizable and could leave significant scar tissue if there are complications in the recovery process.

Because of these reasons, many plastic surgeons now opt to do endoscopic breast augmentation instead. This is an advanced surgical technique where the surgeon uses a tiny camera (an endoscope) to see beneath the patient’s skin.  It may sound a little unusual to those out of the medical field, but the use of endoscopy means surgeons can create smaller incisions in more discrete areas. 

What Is Endoscopic Surgery?

Endoscopic surgery uses an endoscope to see the inside of the body during surgery. During Endoscopy, the surgeon makes a very small incision to insert the endoscope and his surgical instruments.  

Endoscopic surgery is used for a variety of ailments and procedures, such as tubal litigation, gallbladder removal, and knee surgery.  It leaves patients with less risk of scarring and a faster recovery time.  

Types of Endoscopic Breast Augmentation

There are two main types of endoscopic breast augmentation. The difference is the location of the incision.  

A Transaxillary endoscopic procedure refers to an incision in the armpit, or axilla. While a Transumbilical endoscopic procedure refers to an incision made in the navel area.  Both procedures offer great results but the doctors at Wave prefer the Transaxillary method because it is typically considered to be safer and provides more consistent results. 

See more on our Before & After gallery!

Benefits of Endoscopic Breast Augmentation

Endoscopic breast augmentation has become one of the most popular plastic surgery procedures.

There are multiple reasons that people prefer endoscopic breast augmentation over traditional breast surgery.  Some of these include:

No scars are placed on the breast itself: The incisions are one of the biggest reasons people opt for this procedure instead of the traditional breast augmentation.  With the transaxillary procedure, the scar is hidden in a discrete spot in the patient’s underarm.  This means that many people feel less self-conscious because there is no visible scarring.

Nerves and Milk Ducts Remain Intact: When using the endoscopic technique to place breast implants below the muscle, very little breast tissue is damaged.  An endoscope gives the surgeon a detailed view of the interior workings of the breast,  this allows them to be more delicate during surgery.  As a result, fewer nerves and milk ducts become severed in the surgical process.

Postoperative bruising and swelling are minimized:  Endoscopic breast augmentation also offers fewer possible complications. This is because nerves and blood vessels are identified using the endoscope and kept intact wherever possible.  Any bleeding blood vessels can be cauterized electrically, making the procedure virtually bloodless.

Faster Recovery Time: Thanks to this type of incision, the surgeon will be able to preserve much of the existing breast while preparing the area for the implant. This makes the process far more comfortable for patients post-procedure.

Ideal Candidates for Breast Augmentation

As with all surgeries, not every patient will be a good candidate for every type of procedure.  The ideal candidates for endoscopic breast augmentation:

  • Have not had prior breast surgery
  • Do not have significant breast ptosis
  • Do not need excision of breast tissue or skin
  • Have relatively symmetric breasts
  • Do not want extremely large breast implants

For all cosmetic procedures, the patient must be in good health to be approved for elective surgery. This is because this type of surgery typically isn’t a medical necessity. Therefore if the patient is in poor physical health, it may be deemed an unnecessary risk.

Chronic health problems such as diabetes, obesity, or high blood pressure may rule out a candidate for breast augmentation in general. Similar to this, lifestyle risk factors such as smoking or excessive drinking may rule out a candidate.

With particular regard to endoscopic breast augmentation, women with breast malformation or deformation may see better results from traditional surgical procedures. Similarly, patients with cylindrical-shaped breasts or sagging breasts may also be a better candidate for a breast lift of traditional breast augmentation.

The best person to advise you on which type of procedure is best for you is an experienced surgeon. They can examine you, learn about your medical history and offer you tailored, unique advice based on years of experience. 

See more on our Before & After gallery!

The Pre-Op Consultation

During the consultation, a Wave Plastic Surgeon will meet with the patient to establish their goals for the procedure including size and shape preferences.

The doctor will collect and review the patient’s medical history and examine the breasts.   The patient’s breasts and chest are evaluated in terms of their:

  • Width and circumference
    The volume of each breast
  • The symmetry of the breasts
  • The position of the nipple-areolar complex of each breast
  • The position of the inframammary fold (IMF) of each breast
  • The thickness, origin and insertion and insertion of the pectoralis major muscle on each side
  • The elasticity of the skin of the breasts
  • The thickness and quality of the subcutaneous fat of the breasts
  • The presence of any breast masses
  • The presence of enlarged axillary lymph nodes, and the quality of the axillary skin
  • A preoperative mammogram is performed in women over fifty years of age

After the prospective client has been cleared for surgery, the doctor will explain how the endoscopic breast augmentation procedure will be performed and address any questions or concerns that the patient may have.

Doctor using endoscope on patient

The Surgical Process

As we mentioned above, the whole process will begin with a consultation with your surgeon. You should get a physical examination and a health assessment. Your surgeon should then discuss the benefits, risks, and the procedure at length with you.

Your surgeon will advise you of any changes that you need to make before the surgery. This could include quitting smoking, avoiding or reducing dosage for certain medications, or losing weight.

During The Procedure

During the procedure, the surgeon will create a four to six-centimeter incision under each armpit. This incision is placed in line with the skin folds of the armpit so that it will be well hidden once healed.  The surgeon will then introduce an electrical scalpel and an endoscopic camera into the opening.  The camera images are magnified so that the surgeon can identify anatomic structures and work with precision.  

The breast implants can be placed either above or below the muscles of the chest.  However, depending on your surgical needs and goals, our preference is often to place the breast implants in a submuscular pocket (below the muscle).  During this phase, minor adjustments can be made in the shape and dimensions of each breast implant pocket to compensate for any breast asymmetries that were noted during the evaluation. 

Breast implants, either saline or silicone gel (gummy bear), are selected to correspond to the predetermined dimensions.  Breast sizers are used to optimize breast shape, volume, and symmetry.  The implants are then inserted into this new pocket and centered behind your nipple. Silicone implants are inserted as they are. Saline implants are inserted empty and filled when in place.

Once the implants are in place, the incision will be closed with absorbable stitches so that the sutures will not need to be removed. The sutures will then be covered with steristrips which are then covered with a small tegaderm dressing that is water repellant so that the patient can shower the next day.

After The Procedure

Patients can get out of bed and move around the night of the surgery.  However, they will usually require assistance getting in and out of bed for the first few days after the surgery.  They should avoid using their arms to push themselves out of, or lower themselves into bed.  A breast strap is usually given to the patient in the first week or two after surgery to accelerate the descent of the breast implants into their final positions. 

The patient will note a feeling of tightness in the chest for the first few weeks after their surgery.  This typically lasts until the pectoral muscles fully stretch to accommodate the volume of the new breast implants. Patients can usually return to a modified exercise schedule a month after surgery, and transition to full activity six weeks after surgery.

Possible Risks

Like with all surgeries, there are risks to endoscopic breast augmentation. They are rare, but the most common risks include:

  • Infection
  • Nerve damage
  • Bleeding
  • Capsular contracture
  • Rippling
  • Unwanted aesthetic results

Your surgeon should discuss all of this with you before surgery. They should also let you know what to look out for during recovery.

Book a Consultation

Endoscopic breast augmentation offers exceptional results with a minimally invasive procedure. Most women are a good candidate for this type of procedure and the risks are minimal.

You can find out more by contacting Wave Plastic Surgery. We have experienced surgeons at all of our locations across California and would be happy to help you find the right surgery for you, contact us to learn more.

FAQs About Endoscopic Breast Augmentation

If this is your first time undergoing surgery, even minimally invasive surgery, you likely have many questions. Here are the most common questions that patients ask.

Transaxillary endoscopic breast augmentation is a minimally invasive plastic surgery technique.  The method involves inserting breast implants through an incision in the fold of the armpit. This 1 inch incision is used to perform an endoscopic surgery where a small camera aids a surgeon as he creates a pocket for a breast implant and then places it beneath the pectoral muscle. 

Many patients prefer endoscopic breast augmentation because the armpit incision avoids scars on the breast.  This technique also reduces damage to breast tissue and nerves. Because of this, recovery time is much faster and less painful. 

If surgery is necessary to adjust an implant, replace an implant or correct a capsular contracture, it can be done through the original armpit incision. In certain severe cases, a separate incision can be made on the breast itself.

A capsular contracture occurs when scar tissue squeezes the breast implant after a breast augmentation surgery.  While this complication can occur with any incision technique, risks can be minimized.  Our surgeons rarely experience capsular contracture following a transaxillary endoscopic breast augmentation.  This is due to the reduced bleeding and trauma involved with the endoscopic technique.

Our Breast Augmentation Specialists

Plastic Surgeon Peter Lee

Peter Lee

M.D., F.A.C.S.

Dr. Peter is CEO and Chief Surgeon of WAVE Plastic Surgery Center with over 20 years of plastic surgery experience, overlooking 30K+ successful plastic surgery cases. He has mentored master surgeons around the world in state-of-the-art techniques, and has been inducted into the RealSelf 100 & 500 Hall of Fame.

His many accolades and shining results are evidence of Peter’s expertise.

Endoscopic Breast Augmentation Plastic Surgeon Jonathan Schifren 1


M.D., F.A.C.S.

The foundations of Dr. Jonathan Shifren’s practice are beauty, quality and value. He treats each patient as a member of his own family.

He believes that superior surgery is a process, not an operation. It actually begins with an initial consultation, where surgical options are tailored to the patient’s individual anatomy and goals. In the operating room, our shared vision comes to life through precise execution and meticulous technique. Surgery is not over when the operation is completed.

Plastic Surgeon Ben Lee

Ben Lee

M.D., F.A.C.S.

Throughout 20+ years in aesthetic plastic surgery, Dr. Ben Lee has always been passionate about using his skills to impart a lasting, positive impact on the lives of his patients.

“Time and time again, I have witnessed dramatic improvements in a patient’s confidence and well-being after a relatively minor cosmetic or reconstructive procedure. As a surgeon, that brings me great joy.” — Dr. Ben Lee

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