Endoscopic Breast Augmentation
Add volume and bring balance to your breasts through one small incision tucked away in the underarm — a change that works in harmony with your body.
Is this right for you?
Endoscopic breast augmentation may suit you when the volume of your breast tissue no longer matches your frame, and you would like a balanced, natural-looking change. The endoscope lets your surgeon work through one small incision in the underarm. Here is how to tell whether this approach is a good fit for you.
This may be a good fit if
- Women aged 18 and over who are in stable health.
- Breasts that developed little from puberty, or that became smaller after pregnancy, after weight loss, or because of hormonal changes.
- An underarm area that is free of infection or other medical conditions.
- No need for additional work around the areola during the same operation.
This may not be right if
- You have sagging breasts or a widened areola that needs to be addressed at the same time — in that case an implant alone is not enough, and your surgeon will talk through a combined plan with you.
- You currently have an infection or another medical condition in the underarm area.
- You are under 18, when breast tissue is still developing.
How it works
Everything begins with a consultation. The surgeon who will perform your operation assesses your frame, the shape of your chest and breasts, the fat and gland tissue you have now, and the condition of your skin and muscle. You will have routine pre-operative tests and a review with the anaesthetist. Depending on your case, you may also be asked to have a mammogram or a breast ultrasound.
There are a few things to prepare before the day of surgery. You stop any medication containing aspirin for 10 days beforehand, and you do not eat for 6 hours before the operation. The surgery is carried out under general anaesthesia and takes around one hour.
The incision sits discreetly in the hollow of the underarm and is roughly 2–4 cm long, depending on the size of the implant. With the endoscope, the length of the incision depends on the implant volume and the surgeon's skill, rather than on the endoscopic technique itself. The implant can be placed in front of the chest muscle (behind the breast gland) or behind the chest muscle; your surgeon will explain the advantages and drawbacks of each position before you choose together. In some cases a closed drain is placed and removed within 24 hours.
About the implant: the shell is made of silicone (either textured or smooth), and inside it holds saline, highly cohesive silicone gel, or hydrogel. Highly cohesive gel does not spread into the surrounding tissue if the implant ruptures. Implants come in a round shape or a teardrop shape; the choice depends on how much breast tissue you have left and on what you want — with implants under 240 ml, the difference between the two shapes is small.
Realistic expectations
The surgery improves the volume and shape of your breasts, and for many people it brings more confidence. The final result is judged at 2–3 months — the time it takes for the breasts to soften again and the implant to settle. It helps to hold a realistic view of the outcome.
What this will not do
- It will not lift sagging breasts or reduce a wide areola if an implant is placed on its own — those changes call for combined surgery.
- It is not absolutely lasting: the implant may need to be replaced down the line.
- It will not create a breast shape identical to a photo — the result depends on the tissue you already have. In some cases the breasts may not be fully even, may not feel fully soft and natural, or the implant may be felt to the touch.
Recovery
The first few days bring real pain and tightness, along with mild swelling and bruising at the incision. Most people manage this well with the pain relief your surgeon prescribes. The stages below are a rough guide — everyone recovers at their own pace.
- The first few days
- You take pain relief for 3–7 days, depending on the implant volume and position. Mild swelling and bruising appear and then fade. A light dressing change is done after the first day.
- The first week
- Stitches come out at around one week if non-dissolving sutures were used. You can return to gentle activity the next day and go back to work after 2–5 days, depending on what your work involves.
- The first 3 weeks
- Wear a support bra day and night, as your surgeon advises.
- Around 2 months
- You can return to sports and exercise.
- 2–3 months
- The breasts soften, the implant settles, and the result is judged to be final.
Risks & safety
Most breast augmentations carried out by the right principles go smoothly. But as with any surgery, there are still risks worth knowing about beforehand — and knowing them clearly helps you decide well.
- Risks related to the anaesthesia.
- A collection of blood around the implant (haematoma) or a build-up of fluid (seroma).
- Infection (very rare) or air trapped under the skin.
- Poor scarring; folds or visible or palpable rippling of the implant.
- Capsular contracture around the implant, which can make the breast firm or change its shape.
- Implant rupture (very rare), or the implant shifting out of position or rotating.
- A result that is not fully even or not fully natural.
How we do it
For safety and a good result, endoscopic breast augmentation needs to be performed by a specialist in Plastic and Aesthetic Surgery who is thoroughly trained in endoscopy, at a hospital licensed to carry out cosmetic surgery.
At The Gioi Dep, every case includes a pre-operative anaesthesia review by an anaesthesiology and critical care doctor, with monitoring and an inpatient stay after surgery. This is the standard we apply for every patient, not an upgrade you choose.
Frequently asked questions
Will the scar show?
The incision sits hidden in the hollow of the underarm and is roughly 2–4 cm long, depending on the implant volume. The scar fades over time, but like any incision, it remains.
Is the implant placed in front of or behind the chest muscle?
Both positions are possible. The choice depends on how much fat and gland tissue you have left and on what you want, after your surgeon explains the advantages and drawbacks of each position.
Which type of implant should I choose?
An implant can hold saline, highly cohesive silicone gel, or hydrogel; in a round or a teardrop shape. Your surgeon will advise on the type that suits your breast tissue and what you want.
Does breast augmentation affect pregnancy and breastfeeding?
After an implant is placed, you can still become pregnant and breastfeed as normal, with no danger to mother or baby. It is generally wise to wait around 6 months after surgery before becoming pregnant.
Do implants cause breast cancer?
From what is understood today, implants — including silicone gel implants — do not cause breast cancer and do not raise the risk. You should still have regular screening and let your doctor know you have an implant, so the right method of examination can be chosen.
How long do implants last?
Many people keep their implants for years with no major change, but an implant should not be thought of as lasting forever. Implants are usually replaced when you want to improve the look — for example to change the volume, change the shape, or address sagging.
How soon can I go back to work?
Most people return to work after 2–5 days, depending on what their work involves, and go back to sports and exercise after around 2 months.
Will it hurt a lot?
The first few days bring real pain and tightness. Most people manage this well with the pain relief your surgeon prescribes, and feel noticeably more comfortable within the first week.
The next step
Book a consultation to find out if endoscopic breast augmentation is right for you.
The content on this page is for reference only and does not replace a direct examination and consultation with a specialist physician. Surgical outcomes vary from person to person.