The axillary approach for breast augmentation has held significant
appeal to our patients. Its major advantage is the concealed
scar at the apex of the axillary fossa. However, this route
of access underwent legitimate criticism because of its reliance
on blind dissection with the potential for associated secondary
problems, such as implant ascension or distortion, implant misplacement,
hematoma, or postoperative pain. However, with the
use of an endoscopy combined with meticulous surgical technique,
many of these problems have been eliminated, and this
approach has gained widespread acceptance. The endoscopic
approach to transaxillary breast augmentation offers better
visualization, more controlled and precise dissection, better
control of bleeding, and converting a blind procedure with blunt
dissection into the current procedure, in which surgeons are in
full control because the surgeons can visualize the field and
dissect with precision. Furthermore, the type I dual plane dissection
is possible because the surgeons can cut the origin of
pectoralis major accurately. Endoscopic techniques have also
improved the predictability of postoperative results and increased
the safety of patient. In addition, the endoscopic
technique can be used in various ways, such as subpectoral,
subglandular, and subfascial dissection, as well as capsulotomy
or supracapsular dissection in secondary operation cases.