Scarless Breast Implant Surgery

Scarless Breast Implant FAQs

• What does the armpit scar look like?

  The armpit scar normally heals well, is barely noticeable, and looks like an armpit crease. Frequently, the armpit scar is almost “invisible,” which is why many women refer to it as the “scarless” technique.

• What is the recovery after scarless (transaxillary) breast implant surgery?

  Scarless breast surgery is a 45-minute surgery, and you will go home the same day after the surgery. You can expect to have some discomfort / pain for one to three days, and the intensity varies from patient to patient but is well-controlled with pain relief medications and a muscle relaxant. Many women are pleasantly surprised that they have very little pain after the surgery as Dr. Lo uses a special protocol to minimize any pain.

  You can drive in five to seven days if you feel up to it. It is recommended to avoid heavy lifting of anything over 10 pounds for two weeks. It is important to avoid repetitive chest or arm movements such as housework or vacuuming until complete healing has occurred.

• When can I exercise after breast implant surgery?

  Generally, you may begin light exercise two to three weeks after the surgery, such as brisk walking outside or on the treadmill. Lower body exercises may be started as well if you feel comfortable. Upper body exercises may be started at three to four weeks, but chest exercises should be limited in the future. Dr. Lo will discuss the timeframe for return to physical activity and exercise based upon your personal situation.

• Is the armpit incision for breast augmentation safe?

  Yes, it is extremely safe. The cut in the armpit is very superficial and does not interfere with any blood vessels, nerves, or lymphatics. It is less invasive than the nipple or crease incision because the technique does not cut through your breast tissue. Dr. Adrian Lo has developed a specialized technique using an endoscopic system and has performed thousands of breast augmentations through the armpit cut over the last 20 years with no major complications. 

  LEARN ABOUT THE ARMPIT CUT FOR BREAST AUGMENTATION.

• I have a tendency to form bad scars as I have bad scars from previous surgery. Is transaxillary breast augmentation recommended for me?

  Absolutely, the armpit cut is the ideal way to have your implants placed for your breast surgery. The armpit cut usually heals up beautifully even though you may have had bad scars on the rest of your body. You will not have any scars on your breasts. Even if the armpit scar doesn’t heal as well as anticipated, it will not be seen as much as if the scar was on your breast (periareolar or crease incision).

• Should my implant be placed behind or in front of the muscle?

  The pectoralis muscle is the large muscle between your breast and your chest wall that attaches to your upper arm. With the armpit incision or transaxillary breast augmentation, the implant is placed behind the muscle (pectoralis). This gives a natural smooth look, decreases the chance of scar tissue (or capsular contracture) and makes mammograms easier to read. With placing the implant behind the muscle, your muscles will not be damaged and your strength will be the same. Dr. Lo does not recommend placing the implant in front of the muscle with the armpit cut.

• CAN I HAVE MY NIPPLES MADE SMALLER WITH MY BREAST AUGMENTATION?
  • Many women suffer from large nipples that happened after pregnancy and breast feeding or they may have always been disproportionately large.
  • The nipples are often too long and wide causing them to be noticeable in bras and clothing leading to embarrassment. Often women will wear nipple covers or pasties to hide the large nipples.
  • A nipple reduction procedure may be performed at the same time as the breast procedure or as a separate procedure under local anesthesia in the office.
  • The incision or scar is almost invisible and sensation is usually preserved.
  • Surgery time is 30 minutes and complete healing in 2 weeks.
• What is the recovery with the transaxillary breast augmentation technique (the armpit cut) compared to other techniques?

  With the armpit cut, because the cut is more superficial and there is no cutting of your breast tissue, the recovery is often quicker and less painful than other techniques. Dr. Lo’s technique involves a gentle creation of a pocket to place your implants with minimal muscle cutting. Dr. Lo uses an endoscope to make a precise pocket for your implant to give you as much cleavage as possible and a natural look.

• How long do breast implants last?

  While breast implants can last for a long time, they should not be considered lifetime devices. Breast implants may last 10, 15, or 20 years or more but sometimes less than 10 years. No one can predict the exact length of time your breast implants will last; it varies with each patient.

• What if I need to have my implants replaced in the future?

  Whether your implants are silicone or saline, they may be replaced or exchanged through the armpit cut. Dr. Lo uses the same scar or cut from before and can replace your silicone or saline implant with the same size or a different size either larger or smaller. Dr. Lo can also adjust your breast pocket if necessary to accommodate the different implant size.

• Do breast implants have a warranty?

  Yes, your saline or silicone breast implants normally have a warranty for leakage and rupture. If the implants should leak or rupture, the warranty will cover most of the costs of the implant replacement surgery. Dr. Lo will use the same armpit scar to replace your implant. You also have the option of changing sizes to be either smaller or larger and may have the other implant replaced as well (the implant that is not leaking or ruptured). Warranty coverage is provided by the implant company and is subject to change.

• What are the main risks with breast implants?

  Thousands of women safely undergo breast augmentation surgery with breast implants every year. However, there are limitations and risks to any surgery, including breast implant surgery. These include, but are not limited to, the need to replace the implants in the future and implant deflation. There are other risks, including capsular contracture, permanent numbness of the nipples, asymmetry, and the need for future revision surgery. Despite the recent controversy, several large studies have shown no conclusive evidence that women with breast implants are at risk for connective tissue or immune diseases.

• What happens if my saline implant leaks or ruptures?

  A saline breast implant may leak from the shell or fill valve. If the saline breast implant leaks, the saline is not harmful and is absorbed by the body. With any breast implant leakage, the implant will need to be replaced. Usually, the same incision can be used (the armpit cut), and the surgery is much less involved and, therefore, less painful. Recovery is usually much quicker, as it is just a matter of removing the deflated implant and replacing it with a new implant.

• What happens if my gummy bear or silicone implant leaks or ruptures?

  With the new highly cohesive silicone gel implant (gummy bear implant), leakage or rupture is not harmful to patients. These implants are filled with a soft semi-solid silicone that feel like gummy bear candy or jello, which is not absorbed by the body and does not move around the body. It is recommended that you have a mammogram or breast ultrasound every three years to make sure your implants are intact. Replacing the silicone implant can be done through the original armpit scar and is an easier recovery than the original surgery.

• What is capsular contracture?

  The body normally forms a lining around the breast implant; this is called the breast pocket or capsule. Normally, the capsule stays soft and pliable. Capsular contracture is when the capsule becomes thickened. The breasts may feel firm or hard and may have a different shape than they were initially. Severe capsular contracture can occasionally be painful. Additional surgery may be required to remove the capsule (scar tissue). This may not be covered under warranty and would be an additional cost. If you purchased an upgraded warranty, additional surgery for capsular contracture may be covered.

• Will I lose feeling in my nipples after surgery?

  After breast implant surgery, you should have normal nipple feeling or sensation. However, temporary numbness can occur that usually resolves in a few weeks to three months but may take up to one year. Eventually, almost all women will regain normal feeling with time. Permanent numbness of the nipples is rare but can happen. Hypersensitivity can also occur after the surgery but also usually resolves with time.

• What about screening for breast cancer after breast implant surgery?

  After having breast implant surgery, breast self-exams can still be performed, and your doctor will still be able to perform breast examinations. Screening mammograms may still be done effectively. It may be more difficult to take and interpret mammograms. This may be a consideration for women with a family history of breast cancer or other individual considerations. An ultrasound or MRI of the breast or breast biopsy may be required if mammograms are inconclusive.

• What is breast implant-associated anaplastic large cell lymphoma (BIA-ALCL)?

  BIA-ALCL (or breast implant associated anaplastic large cell lymphoma) is an uncommon and highly treatable type of lymphoma that can develop around breast implants. BIA-ALCL occurs most frequently in patients who have textured breast implants although it possibly can occur in any breast implant. This is not true breast cancer but a cancer of the immune system. When discovered early, BIA-ALCL is usually curable. 

  In very rare situations, some patients have developed squamous cell cancer (BIA-SCC) around their implants. The cause is unknown and currently being investigated.

• What is breast implant illness?

  Breast implant illness is a condition that is not entirely understood yet and is being investigated. Some women with breast implants develop symptoms such as anxiety, chronic pain, fatigue, hair loss, depression, and more, and they believe that their breast implants are causing these issues. However, there is no test that can be done to determine a link between breast implants and breast implant illness. Removing the breast implants can often relieve the symptoms. At your consultation, Dr. Lo will discuss your individual circumstances and answer any questions you have.

• Are there any other risks with breast implant surgery?

  There are other risks that may be unique to your situation and will be discussed with you during your consultation. It is important for you to ask any questions you have with Dr. Adrian Lo during your consultation.