Incision	Pros	Cons
Inflammatory fold	Most widely applied globally Applicable to any shape of the breasts Least skin damage during the surgery Least possibility of damaging important nerves and blood vessels Same location for reconstruction Applicable to all types of implants Quickest surgery time	Incision on the cosmetic part of the breast
Armpit	Incision is rarely visible Applicable on both above and below the pectoralis muscle Applicable for all types of implants but one needs to know a special know-how for anatomical implant	Directly visible when conducting the breast augmentation Need endoscope in order to see the axillary crease Can damage important nerves and blood vessels Possibility of lymph complication and bands Different incision part for reconstruction
Areola	Good visual for the augmentation Low possibility of damaging important nerves and blood vessels Applicable to all planes Applicable to all types of implants but require a large sized areola for anatomical implant	Very visible spot for the incision Possibility of tissue damage and bleeding exist Can be exposed to bacteria within the breast Not applicable to large sized implant (if areola is small) Difficult to apply if the areola color is dark
Bellybutton	Incision line is far away from the breast No important nerves of blood vessels	Directly visible to the eyes Low accuracy of desquamation, high possibility of tissue damage Only applicable for saline bag type Different incision spot for reconstruction

There are several number of corrections / surgeries that you can do simultaneously with the transaxillary breast augmentation. We will cover a few in details.

The most common one that the patients ask about is the bra line liposuction.



When you do the liposuction in the forearm, the incision site that you take the fat out from is different from the incision point for the breast augmentation surgery.
We put in the medication that melts the fat into a spot different from the incision spot and conduct the liposuction.

 
Therefore, there is no activity near the arm when we do the breast augmentation surgery. The two are independent from one another.
But, when we do the breast augmentation, we need to sterilize the upper body including the arm and cover the parts with draping; therefore, forearm surgery is easier to conduct.

Bra line liposuction involves removing the fat that sticks out when you wear a bra.




Let’s say that you are standing straight with arm by your sides. The part where forearm and the body meet has much fat. Removing this fat is what we call arm liposuction, and removing the fat on the body is called bra line liposuction.

There are times when you have to do the bra line liposuction on both front and back of the body.
We need to turn the anesthetized patient upside down in order to do the liposuction on the back. Although there is not much fat at the back, we need to move the body leading to spending much time on this procedure.

If you were to have bra line, forearm liposuction, and also breast augmentation that require armpit incision, what would be the order of the three procedures?

The order is as below.



First is the anesthesia.
Then we turn the patient upside down to conduct bra line liposuction on the back (at times we do the liposuction on the back side of the arm as well)
Then, we turn the patient back to the normal position and conduct breast surgery.
After implant and the rest of the procedure are complete,
We continue with the bra line on the front part of the body and the forearm.
When the liposuction is complete, we stich up the incision on the armpit
We dress with the compression bandage and complete the procedure. 

If the surgery is conducted in such a way, it is completed rather quickly although it requires many steps.

Second is the removing Axillary breast tissue
This is not much different from the bra line front part liposuction. Although the conditions of the two corrections are different, the methods are the same.


Third is the axillary osmidrosis treatment
Axillary osmidrosis treatment involves minimizing the apocrin sweat gland on the armpit.
This procedure requires using suction tool. We use this to scratch the layer under the skin to suck in and damage the apocrin sweat gland.



We are damaging the apocrin sweat gland so that the sweat does not come out easily.
This treatment is simple to do therefore; it can be done simultaneously with the transaxillary breast augmentation as well. First we need to do axillary osmidrosis treatment then do the transaxillary breast augmentation.

Today, we looked at some of the other corrections or surgeries that we can do together with the transaxillary breast augmentation. By doing several procedures simultaneously, the patient can save cost and also shorten the recovery time.

However, this might be more stressful on the body, and the patient might need to be more careful with her body during the recovery time.

This is for now. Thank you very much.