Morphologic Changes of the Breast after Implant-Based Endoscopic Transaxillary Augmentation in East Asian Patients

Breast augmentation with implants is commonly performed among East Asian patients, but few studies have analyzed how breast morphology changes postoperatively. This study evaluated these changes in this population.

This was a single-surgeon retrospective review of East Asian women who underwent primary endoscopic transaxillary breast augmentation from 2019 through 2024 using the same profiled silicone implants. Patients with massive weight loss or breast ptosis were excluded. Measurements included suprasternal notch to nipple, nipple to inframammary fold, base diameter (BD), areola height, and areola width, measured manually preoperatively and 1 week, 1 month, 3 months, 6 months, and 1 year after surgery. Paired t test was used to compare average measurements and changes.

In total, 184 breasts (92 patients) were analyzed. The average increase in absolute measurement and percentage change (regardless of implant size) between preoperative measurement and 1 year was 1.4 cm (7.7%) for suprasternal notch to nipple, 2.3 cm (42.6%) for nipple to inframammary fold, 0.4 cm (3.2%) for BD, 0.7 cm (26.6%) for areola height, and 0.7 cm (21.4%) for areola width. At 1 year, all measurements except BD showed significant changes from preoperative values.

The findings of this study suggest that in primary transaxillary breast augmentation in East Asian patients, placing implants of any volume that match the native base diameter results in outward anterior expansion, with preferential lower-pole distension over time and minimal change in breast footprint. The upper pole stretches less than the lower pole, and the nipple remains stable to the chest wall within the first year. These data offer insights into the breast's natural morphology and postoperative course, aiding future augmentation consultations.