title: Subfascial transaxillary breast augmentation without endoscopic assistance: technical aspects and outcome.
abstract: BACKGROUND
  Although transaxillary breast augmentation (TBA) is a well-studied procedure, few previous reports exist concerning the subfascial technique, especially without endoscopic assistance. This study aimed to analyze the feasibility of the technique after breast augmentation in terms of its indication, surgical technique, limitations, and clinical outcome.
  
  
  METHODS
  For this study, 42 patients underwent TBA without endoscopic assistance. The technique was indicated for patients with breasts of small or moderate volume without ptosis, patients who wanted no breast scars, and patients who had a poorly defined inframammary fold. The mean follow-up period was 16 months. Implant and incision approach complications were evaluated. Information on patient satisfaction was collected.
  
  
  RESULTS
  A total of 14 complications occurred in 42 patients, all of them minor. Axillary incision-related complications occurred in 26% of the patients, as represented by a late axillary subcutaneous band (119%), sensory loss in the inner aspect of the arm (71%), and a hypertrophic scar and small wound dehiscence (71%). No patient presented with capsular contracture, visible rippling, or infection. Most of the patients (93%) were either very satisfied or satisfied with their result, and none regretted the surgery.
  
  
  CONCLUSIONS
  The TBA procedure without endoscopic assistance is a simple and reliable technique for breast augmentation. Most of the complications in this study were minor and predictable. They did not interfere with the aesthetic outcome nor the normal postoperative recovery. With TBA, success depends on patient selection as well as careful intra- and postoperative management.
authors.affiliation: Division of Plastic Surgery, University of São Paulo School of Medicine, Rua da Consolação 3605 ap 91, 01416-001 São Paulo, SP, Brazil. munhozalex@uol.com.br
authors.forename: Alexandre M
authors.initials: AM
authors.lastname: Munhoz
authors.forename: Klaus
authors.initials: K
authors.lastname: Fells
authors.forename: Eduardo
authors.initials: E
authors.lastname: Arruda
authors.forename: Eduardo
authors.initials: E
authors.lastname: Montag
authors.forename: Alberto
authors.initials: A
authors.lastname: Okada
authors.forename: Claudia
authors.initials: C
authors.lastname: Aldrighi
authors.forename: José M
authors.initials: JM
authors.lastname: Aldrighi
authors.forename: Rolf
authors.initials: R
authors.lastname: Gemperli
authors.forename: Marcus C
authors.initials: MC
authors.lastname: Ferreira
mesh_terms: D000293:Adolescent; D000328:Adult; D001365:Axilla / Q000601:surgery*; D019928:Breast Implantation; D004724:Endoscopy; D004954:Esthetics; D000071938:Fasciotomy; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome