If you have been considering breast augmentation , you probably already know that there are four different incision options for placing the breast implants: around the areola (periareolar), under the breast (inframammary), in the armpit (transaxillary), and in the navel (TUBA). Two of these options (periareolar and inframammary) are traditional surgical methods, and two of them are endoscopic surgeries (transaxillary and TUBA), which involve incisions far from the breast. Doctors who perform endoscopic surgeries promote them as being both more discreet and less invasive, but are they good options?

How Endoscopic Surgery Works

Endoscopic surgery works using a tool known as an endoscope, a long, narrow tube that allows tiny surgical instruments to be inserted at a point very far from the actual site of surgery. The doctor can look at the surgery via a video camera on the endoscope, and he can manipulate the instruments remotely. It allows for very small incisions and can allow for very precise work without damaging or moving nearby tissue. In order to insert the breast implant via the navel or the armpit, the implant must be deflated and rolled tight. This allows the implant to be moved from the incision site to the breast via tiny tracks created under the skin.

Endoscopic surgery does allow for very small incisions that can be far from the breast. In some cases, it also allows for very quick recovery, and it does allow for placement of the implants both under the breast (subglandular placement) and under the muscle ( submuscular placement ).

Options

Because breast implants must be deflated when placed via endoscopic surgery, and silicone breast implants come pre-filled from the manufacturer, endoscopic breast surgery cannot be performed for silicone breast implants. If you want silicone breast implants, you cannot get endoscopic breast surgery.

Results

One of the main problems with endoscopic breast surgery is that it can be very hard for doctors to achieve symmetrical pockets for the breast implants. Endoscopic breast augmentation surgeries tend more often to have asymmetric results, with one breast sitting visibly higher than the other. If you are considering endoscopic breast augmentation, make sure you look at all a doctor's before and after picks, not just the few cherry-picked ones online or in a small book, to get a better idea of how likely you are to see results that are off-kilter.

Revision

It is very rare that revision surgery for endoscopic breast augmentation can be done endoscopically. Normally, it requires an inframmamary incision be used, although sometimes a periareolar incision may work as well. Since about one-third of women need a revision surgery in the first three years after getting breast augmentation, you may end up with an inframammary incision even if you elect endoscopic surgery the first time.

Discreet?

The main argument for endoscopic breast surgery is that it is "secret." Endoscopic breast augmentation puts the incisions far from the breasts, which hopefully prevents people from learning that you have had breast implants. This can work very well if the incision heals well, but if the incision heals badly, if it remains a visible scar or, worse, becomes a highly visible keloid, it can be awkward. A woman with a keloid scar in the underarm area will be self-conscious in any kind of sleeveless outfit, including a swimsuit. And a keloid in the navel makes midriff-baring outfits uncomfortable and essentially rules out any bikini. Since feeling less self-conscious in clothes, especially swimsuits, is the main reason why women want breast augmentation surgery, this is potentially a very serious down side.