Patients who want no breast scarring at all often opt for the more difficult transaxillary incision. This incision is made in the armpit and leaves a tiny scar that is virtually impossible to see.
The transaxillary procedure can be preformed with or without the help of an endoscope (a tube with a small surgical camera on the end). The cut is made in the fold of the armpit and a channel is cut to the breast. The implant is inserted into the channel and worked into place.
Transaxillary incision presents a greater challenge for surgeons because working that far away from the breast makes placement more difficult.
Like nipple and crease incisions, the armpit incision can be used for implant placement anywhere in the breast. The biggest draw back of the transaxillary incision is that if a complication occurs that requires revision or removal, then chances are the surgeon will have to make a nipple or crease incision to work on the implant. It is very rare that surgeons can reuse the transaxillary incision -- it's very difficult to work on an implant that far away from the breast.