Endoscopic Transaxillary Versus Inframammary Approaches for Breast Augmentation Using Shaped Implants: A Matched...

Breast augmentation surgery involves multiple incision approaches, each with distinct advantages and risks. The inframammary fold remains the most widely used due to its accessibility and visibility of the scar. In contrast, the transaxillary approach is favored in certain regions for its less visible scar placement. However, the long-term outcomes of these approaches when using shaped implants remain unclear. Prior research has shown that implant type and surgical technique influence complication rates, but few studies have directly compared transaxillary and inframammary approaches using shaped implants. This gap motivated a study to evaluate whether the transaxillary method could serve as a viable alternative. No prior work had resolved whether shaped implants influence the relative safety of these two incision types. Understanding these outcomes is crucial for surgeons seeking to minimize visible scarring while maintaining safety. This study aims to provide evidence-based guidance for surgical decision-making. The need for a matched case-control design arises from the variability in patient characteristics and implant use.

This study aimed to compare the outcomes of endoscopic transaxillary and inframammary approaches in breast augmentation using shaped implants. The specific problem addressed is the lack of direct comparison between these two incision methods regarding complication rates and patient satisfaction. The motivation stems from the increasing demand for less visible scarring options, particularly in regions where conservative scarring is preferred. The authors sought to determine whether the transaxillary approach is non-inferior to the inframammary approach in terms of safety and outcomes. By matching implant types and patient demographics, the study aimed to eliminate confounding variables. The goal was to assess whether the transaxillary method could serve as a valid alternative for patients seeking less visible scarring. This comparison is essential for surgeons to make informed decisions based on patient preferences and anatomical factors. The study's design allows for a focused analysis of complication rates and long-term outcomes.

The study employed a matched case-control design, comparing two surgical approaches for breast augmentation. Three hundred sixty-four patients were enrolled, with 195 using the inframammary fold and 169 using the endoscopic transaxillary approach. All patients received anatomically shaped implants in primary, bilateral procedures. Patient demographics, implant types, and complication data were collected. Complications were tracked over an average 27-month follow-up period. Capsular contracture, hematoma, infection, and implant malposition were among the recorded outcomes. Endoscopic techniques were used in the transaxillary group to minimize scarring. Statistical analysis compared complication rates between the two groups. The study ensured implant size and type were matched across both groups to control for variability.

Complication rates were 1.8% for the inframammary group and 2.7% for the transaxillary group. No significant difference in surgical complications was found (p = 0.593). Capsular contracture occurred in both groups but was not statistically different. Hematoma and infection rates were low in both approaches. Implant malposition was reported in a small number of cases. Chronic seroma was also observed but did not differ significantly. The transaxillary approach showed no increased risk of complications compared to the inframammary method. These findings suggest that the transaxillary approach is not inferior in terms of safety and outcomes.

The study demonstrates that the endoscopic transaxillary approach is not inferior to the inframammary approach when using shaped implants for breast augmentation. The authors state that complication rates were comparable between the two methods. The transaxillary approach may serve as a valid alternative for patients seeking less visible scarring. No essential difference in safety was observed between the two approaches. The authors propose that surgeons may consider the transaxillary method based on patient preferences and anatomical suitability. The findings do not suggest a preference for one approach over the other in terms of complication risk. The authors emphasize the importance of patient-specific factors in choosing an incision site. The study supports the use of transaxillary incisions as a viable option for breast augmentation with shaped implants.