Dr. Shuster is one of a handful of surgeons specializing exclusively in the transaxillary method. While there are misconceptions regarding implant type and placement with the transaxillary method, they are mostly due to lack of surgical experience in this area. Dr. Shuster possesses years of experience with this technique and performs this method exclusively for primary breast augmentations. 

Dr. Shuster recommends placement under the muscle so that more tissue covers the implant for a more natural result.

This approach makes the most sense of all the methods for placing breast implants because the side of the pectoralis muscle is immediately adjacent to the armpit. This allows direct placement of the implant with no trauma to, or cutting through, the breasts.

Additional benefits of placing the implants under the muscle are that there are fewer complications, the implants hold up better over time, there is less chance of rippling or capsular contracture, and it interferes less with mammography. 

Saline implants are popular, as fluid within a saline implant poses no threat to the body and is absorbed should a leak or rupture occur. Natural results are achieved due to the implant arriving deflated, thus allowing Dr. Shuster to make a smaller incision. Once in place, the implant is appropriately filled with fluid to achieve the desired level of size, firmness and fullness. 

Round implants tend to provide greater lift, fullness and cleavage. They can have either a smooth or textured surface. Because they are symmetrical, there is no risk of implant rotation.

Teardrop implants (also known as contoured or anatomical breast implants) theoretically provide a more gently sloping contour and they often provide greater projection by volume than round implants. 

A significant problem with the shaped implants is the potential for these implants to rotate and compromise the results. While these implants were popular in the 1990’s they may occasionally be of benefit for women today. If you have an interest in shaped implants, Dr. Shuster can discuss these with you in detail. 

A low profile ensures the breasts do not project too far out from the body. These low profile implants will provide the most subtle and natural results. For many women who select a low profile breast implant, they will have a significant increase in size though other may not be able to tell they had an augmentation. 

Medium profile breast implants provide more fullness and can still create a natural appearance. Others may wonder if a woman with these had a augmentation but not be sure. 

Higher profile implants provide the most projection but look more augmented. These implants are best suited for women who prefer a fuller look and are less concerned with a natural appearance.

As part of Dr. Shuster’s dedication to his patient’s safety and well-being, he performs surgeries at the Memorial Same Day Surgery Center, a fully accredited ambulatory surgical facility, part of Memorial Healthcare System. Dr. Shuster has a dedicated surgical and anesthesia team, who have worked with him for over 10 years. They are extremely fluent in patient safety and breast augmentation. From the moment his patients enter the center, they immediately feel comfortable with the staff because of their clear level of experience and expertise.

Dr. Shuster places a 2 inch incision high in the arm pit. Through this he can approach the pectoralis muscle from the side rather than having to cut through it as with other methods. He then creates a space under the muscle, referred to as the ‘pocket’. Dr. Shuster always places implant samples, sizers, to confirm the best size, shape and position.

Determining the final best implant for any patient is something Dr. Shuster gives much thought to. His considerations are which implant works best from an anatomical point of view with his patient’s body and secondly, are these results achieving or exceeding his patients goals.

With the best breast implants selected, Dr. Shuster applies the final touches to the pockets to achieve the most optimum result possible. 

Dr. Shuster performs breast augmentation under general anesthesia. He has a team of anesthesiologist and nurse anesthetist who have worked with him for years. He also uses long lasting local anesthetics for his patients comfort. With his expert anesthesia team, he can focus on the quality of the result.

As with any surgery, recovery after transaxillary breast augmentation is a gradual process. Overall, recovery from the transaxillary method is not difficult. There is typically swelling and bruising that develop, it most cases to a minor extent. The implants may temporarily seem high. Bruising and swelling mostly subside over 2 weeks. The breast implants will settle into their natural position over 6 to 12 weeks. Depending upon your occupation, anticipate at least a 4-5 day recovery period prior to returning to work or light activity. You may resume non-impact lower body exercise in 1-2 weeks and impact exercise in approximately 4 weeks. Upper body exercise can be resumed 6 weeks after surgery. 

Details of the Recovery after Transaxillary Breast Augmentation

Dr. Shuster’s approach to a smooth and easy recovery is preparation. In our practice this begins when the surgery is scheduled. Each patient receives a detailed set of instructions on how to plan for their procedure, both before and after. We make sure that our patients are well informed, have thought through and are ready for the postoperative period. Again, Dr. Shuster believes that the best way to have the easiest recovery is to be well informed and prepared.

Some of the essential components of his approach to recovery include maintaining a low sodium diet after breast augmentation. This is the most important thing a patient can do to minimize their swelling as sodium leads to fluid retention. By minimizing the amount of swelling that develops, patients will have less edema to resolve, feel better and look better. Patients can plan which low sodium meals or snacks they like and have them prepared and ready prior to surgery. Another consideration is to prepare their personal “Recovery Station”. This is the area at home where patients will be spending most of their time for several days following the procedure, usually their bed. Prior to surgery, anticipate everything you may want within reach and arrange it prior to the procedure. Popular items are bottled water with the caps loosened, prescriptions, lip balm, phone charger, and extra pillows.

The first night after a transaxillary breast augmentation, patients should be prepared to sleep on their backs with their back elevated on several pillows. Dr. Shuster places long lasting local anesthetics around the breast implants at the time of surgery. This will last long into the evening.

 As this wears off patients usually develop more discomfort. Prescriptions for both pain medications and muscle relaxants are provided and should be filled prior to the day of surgery. Patients should limit heavy lifting and reaching with their arms but may use them enough to take care of themselves. Because there is an incision in the armpit, deodorant should not be used after transaxillary breast augmentation until Dr. Shuster advises.

Dr. Shuster personally keeps a close eye on his patients during their recovery. He will see each of his breast augmentation patients personally the day after surgery. This visit is one of the most exciting times for patients as he will remove the post-surgical bra and they can see their new breasts for the first time. While bruising and swelling are normal, the breasts will already look terrific. Plan on having someone bring you to this postoperative appointment.

Following transaxillary breast augmentation, patients should plan on staying home and taking it easy for 4 to 5 days. Most patients can resume light activity at this time. Depending on peoples’ occupation, they can usually return to work as early as 5 days after surgery. For others who have more active jobs this maybe 7 to 10 days or longer. Light exercise can be resumed as early as 7 days after surgery. Dr. Shuster particularly likes a recumbent, stationary bike for patients who are eager to return to the gym. It allows women to get in some cardio while not creating any stress on the upper body. Exercise can advance gradually over 4 to 6 weeks with patients having no limits on exercise at that time.

Dr. Shuster uses a specific bra for his patients with transaxillary placement of breast implants. Initially, the breast implants will sit high on the chest. Over the course of several weeks the implants will settle into position as the swelling resolves and the tissues stretch. During this recovery period, Dr. Shuster advises his patients not to wear under wire, padded, or push-up bras as these may prevent the implants from settling well.

Of course for each of his transaxillary patients Dr. Shuster will guide them as to what is most appropriate for their individual case during postoperative visits. For patients who live out of the area and travel for their surgery, Dr. Shuster will schedule on-line video follow up appointments to monitor their progress.