"A Systematic Review and Meta-Analysis of 11,686 Breasts Undergoing Transaxillary Augmentation: Why Leave a Trace...

Area of Science:

• Plastic Surgery
• Aesthetic Surgery
• Surgical Outcomes

Background:

• Breast augmentation (BA) is a common plastic surgery procedure globally.
• The transaxillary approach (TAA) for BA is gaining popularity due to its scarless outcome.
• Limited and varied evidence exists on the safety and effectiveness of the TAA.

Purpose of the Study:

• To evaluate the safety and outcomes of primary breast augmentation (PBA) using the transaxillary approach (TAA).
• To compare TAA outcomes with other incision methods for BA.
• To assess patient satisfaction and complication rates associated with TAA.

Main Methods:

• A systematic literature review and meta-analysis of studies on TAA for primary breast augmentation.
• Searched databases including MEDLINE, Embase, Scopus, Cochrane, and Web of Science up to May 2025.
• Included studies focused on adult women undergoing primary BA with silicone implants via TAA, analyzing outcomes like capsular contracture, patient satisfaction, infection, and reintervention.

Main Results:

• Twenty-two studies with 5,843 patients were analyzed.
• Patient satisfaction with TAA was consistently high.
• Meta-analyses revealed no significant differences in capsular contracture, reintervention, or infection rates between TAA and other incisions.
• Pooled incidences for TAA showed low rates of capsular contracture (2.3%), reintervention (3.3%), infection (0.7%), hematoma (1.4%), seroma (1.4%), and implant rupture (1%).

Conclusions:

• Primary breast augmentation via the transaxillary approach is a safe and effective procedure.
• Complication rates are comparable to traditional inframammary and periareolar incisions.
• The TAA technique demonstrates uniformly high patient satisfaction and favorable safety profiles.