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Dear Dr. Togba,

Q.  One of my girlfriends just had her breasts enlarged. The surgeon put the implant through the armpit underneath the muscle and she said it was all done on a TV screen. Is this possible?

A. Yes. A popular technique in cosmetic breast augmentation are implants inserted through a one inch incision in the armpit, then positioned partially under the muscle. This surgical approach has the advantage of giving a more natural shape to the breast, which is an improvement over the appearance when the implant is placed totally under the muscle. This procedure has become possible because we are now using an endoscope which is a wand with a bright light and camera attached to it so that the surgeon is able to view what he is doing on a TV monitor just like when an orthopedic surgeon does knee surgery. To perform the surgery, a separate surgical instrument called an electrocautery must be inserted through the same entry point. The tiny "eye "of the endoscope’s camera allows a surgeon to view the surgical site more clearly than if the skin were opened from a long incision. There are other advantages with this procedure: risk of sensory loss from nerve damage is decreased and the recovery time is frequently shortened.

Dr. T