Do you wish for a larger bust but would prefer to avoid any scar on the breast itself? Then breast augmentation through the armpit is well worth a closer look. With this technique, the implant is placed through a small incision in the armpit – under camera guidance (endoscopically). The breast remains free of scars. In this article, you will learn how the procedure works, what its advantages and limitations are, and who it is suited for.
What is transaxillary endoscopic breast augmentation?
“Transaxillary” means that the access is made through the armpit (Latin axilla), not through the breast. Instead of an incision in the inframammary fold or around the areola, the silicone implant is placed through a small incision within a natural skin crease of the armpit. So that the pocket for the implant can be created precisely and under direct vision, I work endoscopically – that is, with a small camera that transmits a magnified view of the surgical field to a monitor.
Access through the armpit is an established method of aesthetic breast surgery and has been studied and refined in the medical literature for years.
The decisive advantage: no scar on the breast
This is the reason many women choose this route: it is the only access in which the breast itself remains completely free of scars. The only – small – scar lies hidden within a natural crease of the armpit and, once healed, is usually difficult to detect. The décolleté, areola and inframammary fold remain entirely untouched. Particularly if you are prone to conspicuous scarring (such as keloids) or are determined to avoid a visible scar on the breast, this route is especially worth considering for you.
How does the procedure through the armpit work?
The procedure is performed under general anaesthesia. The sequence in brief:
- Incision: a small incision within a natural crease of the armpit.
- Endoscopic dissection under direct vision: A fine HD camera transmits a magnified view of the surgical field to a monitor. This allows me to prepare the pocket for the implant precisely and with care for the tissue – with meticulous haemostasis and accurate shaping of the implant pocket, unlike the blind palpation through the armpit that was common in the past.
- Implant position: Depending on the findings, I place the implant using the dual-plane technique (partially beneath the chest muscle) or subglandularly (above the muscle, beneath the gland) – matched to your tissue and your desired result.
- No-touch insertion (Keller funnel): Using a funnel-shaped insertion aid, the implant glides into the prepared pocket by the no-touch method – with minimal contact with skin and bacteria. This is regarded as a measure that may reduce the risk of capsular contracture.
- Closure: fine wound closure in the armpit.
The endoscopic technique is central here: it replaces “blind” palpation with controlled dissection under vision – an aspect discussed in comparative studies as an advantage in terms of precision.
Why endoscopically? The advantages of direct vision
Access through the armpit was once a technique performed without direct vision. Endoscopy has fundamentally changed this: today I perform the procedure under direct vision. This brings concrete advantages for you:
- Precise haemostasis under vision, which can reduce bruising.
- Accurate shaping of the implant pocket for a harmonious, natural result.
- The inframammary fold remains untouched – this contributes to the stability of the implant position and helps prevent the implant from descending.
Which implants and which positions are possible?
Through the access in the armpit, both round and anatomical (teardrop-shaped) silicone implants can be placed. Which size, which profile and which position are suitable for you depends on your individual starting situation – on your chest, the quality of your skin and your desired result. You can find more about the implant shapes on our page on breast augmentation with implants.
I use micro-textured silicone implants. Their finely structured surface supports a stable position within the tissue and combines properties of smooth and more heavily textured implants in a balanced profile.
Who is the armpit method suited for – and who not?
Well suited if:
- you wish for a scar-free breast and would rather hide the scar in the armpit,
- this is a first breast augmentation,
- your skin and tissue quality is good and there is no pronounced sagging.
Less suited if:
- there is significant breast sagging (ptosis) – in which case an additional breast lift is usually needed, which cannot be performed through the armpit alone,
- previous operations already make the access more difficult.
Whether the method is the right one in your case is something we assess together during a personal consultation.
Advantages and limitations at a glance
| Advantages | Limitations |
|---|---|
| No scar on the breast – hidden in the armpit | Not sufficient on its own in cases of pronounced ptosis |
| Endoscopic dissection under direct vision | Requires good skin/tissue quality |
| Untouched décolleté and areola | Revision procedures may require a different access |
| Inframammary fold remains untouched – stable implant position | Requires endoscopic experience on the part of the surgeon |
A real fitting instead of 3D simulation: my personal method
Many practices advertise digital 3D simulations on screen. I deliberately take a different approach. With me, you try out different sizes directly using real trial implants (sizers) – you see and feel the volume and weight immediately on your own body. This tactile sense of your own body gives you a more honest impression of the result than any image on a monitor.
On this basis, we then choose together the implant that best suits your individual breast footprint, your breast base and your natural breast shape. This way it is not software that makes the decision, but you – together with me.
Frequently asked questions
Does the breast really stay free of scars?
Yes. The only incision lies within the crease of the armpit. No scar arises on the breast itself.
Can I breastfeed after a breast augmentation through the armpit?
Since the areola and milk ducts are not divided, the ability to breastfeed is generally not affected by this access. However, the ability to breastfeed can never be guaranteed in general.
Is the method suitable for every woman?
No. It is particularly suited to a first breast augmentation without pronounced sagging. In cases of breast ptosis, an additional lift is often advisable.
Literature & Scientific Sources
- Luan J. “Endoscopic-Assisted Transaxillary Breast Augmentation.” Clinics in Plastic Surgery. 2023. PubMed PMID 36396254
- Boliglowa D et al. “Trans-axillary breast augmentation: a Randomized Controlled Trial comparing a new semi-endoscopic video-assisted technique versus the blind technique.” Plastic and Reconstructive Surgery. 2025. PubMed PMID 41115293
- Dominic JL et al. “Endoscopic Transaxillary Approach for Breast Augmentation: What does the Evidence Say and What Else Can be Done?.” Aesthetic Plastic Surgery. 2022. PubMed PMID 34561726
- Lee DW et al. “Endoscopic Transaxillary Versus Inframammary Approaches for Breast Augmentation Using Shaped Implants: A Matched Case-Control Study.” Aesthetic Plastic Surgery. 2019. PubMed PMID 30911772
- Sim HB et al. “Transaxillary endoscopic breast augmentation with shaped gel implants.” Aesthetic Surgery Journal. 2015. PubMed PMID 26104477
- Strock LL. “Transaxillary Breast Augmentation: Selection of the Incision, Pocket, and Surgical Technique.” Clinics in Plastic Surgery. 2026. PubMed PMID 41826043
Medically reviewed and written by Alejandro Marti – Specialist (Facharzt) in Plastic and Aesthetic Surgery (DE & ES). Last reviewed: June 2026.
