Frequently asked questions

Frequently asked questions

This section is dedicated to answering the most frequently asked questions we receive from our patients about cosmetic procedures performed in our clinic.

What are the advantages of the endoscopically assisted axilla technique?
Today, this technique is our number one recommendation and we can say without reservation that any implant that can be inserted with the classic technique under the breasts can also be inserted with the underarm technique. In fact, the classic under-breast procedure is only indicated if the patient does not want the underarm technique. Of course, in order to opt for the underarm breast implant, it is important that the plastic surgeon's experience with the underarm technique is sufficiently advanced. Currently, less than 1% of plastic surgeons worldwide practice this technique.

The advantages of the endoscopically assisted axillary technique are:

  • NO breast scars; the scar is located in a fold of the armpit, making it difficult to see even with arms raised, even to an experienced eye

Consider that scars are FOR LIFE! They cannot be erased by laser or any other surgical or medical technique, so once done they will be PERMANENT. For this reason, it is very important that the scar is hidden in a fold under the arm, away from the breasts. For example, when you lie on your back, the scar is not visible (because there is no scar on your breasts), but this is not the same when the scar is present under your breasts, it stands out even more. In the armpit the scar is hidden in a fold, is very hard to detect and does not attract the eye.

  • The scar under the arm always heals much better than in other areas because the area is mobile and folded, where the scar can easily be hidden.
  • The risk of loss of nipple tenderness and breast skin from the nipple down to the inframammary fold is much reduced as the scar is placed away from the breast, under the arm.
  • In the long term, there is much better stability of the implant in the breast as there is no severing of the inframammary groove ligament, as there is with the under-breast technique.
  • Dissection is performed using state-of-the-art nanotechnology tweezers, similar to atraumatic robotic surgery, so recovery is much faster and safer, reducing operating time and hospitalisation.
  • The precision with which the operation is performed is much greater than in traditional surgery under the breasts, as the operation is visualised on a monitor that enlarges the operating field approximately 5 times, similar to robotic surgery.
  • The risk of the scar splitting with the exposure or exit of the implant, which is present with the under-breast technique due to the tension (pressure) created by the breast implant in the breast, is practically non-existent with the underarm technique, as there is no tension (pressure) in the armpit, which is present in the breast.
  • Any kind of bra can be worn, including those with braces (whalebones), as they do not press or embarrass the scar (as can happen when the scar is under the breast).
  • The implant can be positioned either in front or behind the pectoral muscle. If you later wish to change the implant for a larger or smaller one, the procedure can be performed through the same scar under the arm.
  • There is no risk of deforming the lower pole of the breast as can happen in some cases due to scarring under the breasts which can alter the appearance of the breasts at the bottom (scar retraction).
  • The nodes under the arm, the sentinel node and the nerves under the arm are not affected in any way.

Today, endoscopic-assisted underarm breast implantation is the most advanced breast augmentation technique using state-of-the-art technology in the field. This procedure is our main recommendation and we were the first to introduce it in Romania.

What is the procedure itself?
Breast implants are placed either in front of or behind the pectoral muscle through a minimal incision of about 3-4 cm placed in a crease at the tip of the axilla. At the time of healing, the scar is hardly detectable, as it is well hidden in the fold/fold under the arm. The implants are placed using an endoscope (in popular terms also known as a 'laser') connected to a monitor, in 3D, which allows the surgeon to visualise the operating field and the design with maximum precision and clarity.
Why is this incision (cut) chosen by patients for implant placement?
Many patients prefer this type of incision because it is the only way to avoid scarring of the breast and to avoid cutting the breast tissue when placing the implant. Normally, the scar under the arm heals extremely well and is barely detectable.

So, first of all, NO BREAST SCARS!

Other advantages are that the accuracy with which the procedure is performed is greater, as it is performed on a monitor that increases the operating field by approximately 3 times.

Special nanotechnology tweezers are used, atraumatic and similar to robotic surgery.

Recovery is faster and the risk of desensitisation (loss of sensitivity or numbness) of the breast and nipple skin is lower than with the traditional technique.

On top of that, the risk of the implant coming out or being exposed through the cut under the breasts (existing with the classic technique under the breasts) is practically ZERO! In the case of the under breast cut, due to the high pressure on the scar, sometimes the scar can open and the implant can be exposed through the under breast cut.

Is it more difficult to place implants through the armpit?
In fact, it's easier for a surgeon trained in this operation. The dissection is done under direct endoscope control, 3D monitor viewing and magnification of the operating field with maximum precision. The breast tissue is lifted without being sectioned and the implants are placed precisely in the correct position
Is this axillary approach technique more painful?
Under no circumstances. Although each person's sensitivity threshold varies quite a bit, generally following this procedure there is a painful, muscle fever-like discomfort that is felt for the first few days, but which eases slightly when pain killers are taken. Recovery is usually quicker with this technique, as the incision is placed at a distance from the surgical site and the operation is performed using special atraumatic nanotechnology tweezers, similar to robotic surgery.
Can the implant be placed under both the mammary gland and the pectoral muscle?
Of course, with equal precision the implant can be placed either behind the mammary gland or behind the pectoral muscle, including the "dual plane" technique.
Is there a higher risk of infection?
No, no way! Studies have shown that the risk of infection is the same regardless of where the incision (cut) is placed and very low. As a result, there is no increased risk of infection with this procedure.
What care is needed after this type of intervention?
Care is very simple. You can shower daily, then apply Betadine and an antibiotic ointment (Baneocin). The sutures dissolve on their own and do not need to be removed. The arms can be raised above the head.
Will this type of incision (cut) affect me medically in any way?
No! With this type of surgery, no deep structures in the armpit - such as nerves, lymph nodes or large blood vessels - are affected.
How does the incision under the arm heal? And how will it look after healing?
The incision is generally between 3-4 cm (for silicone implants), normally healing in a crease under the arm, so to the untrained eye it is not detectable (see clinic website). We consider it to heal better than a scar under the breast or around the areola (nipple), as it is in a skin fold where the skin is lax and mobile (like the upper eyelids where there are also generally barely detectable scars).

implant
Underarm implant
Implant clasic
Classic implant
Cicatrice dupã un an
Scar after one year
Cicatrice dupà zece ani
Scar after ten years
What happens if a re-operation to adjust/change implants is needed in the future?
If in the future a second implant adjustment or replacement, or correction of a capsular contracture, is needed, this can be done through the initial incision made under the arm. Only in rare or severe cases may a separate breast incision be necessary.
What are the results like with implants inserted endoscopically through the armpit?
In our practice, we can say that the results obtained with this technique are really excellent. The patients are extraordinarily satisfied with the result and the fact that they do not have any scars on their breasts (see our patient references).
If the implant is inserted under the breasts, is the scar more visible?
Although we are the first to report reducing the scarring under the breasts to just 3 cm, in some cases the scarring becomes visible and sometimes even disturbing. It can stand out when the patient lies on her back in bed or if she wants to sunbathe topless.

În schimb, prin plasarea cicatricii sub braț, există mari șanse ca nimeni să nu-și dea seama că aveți implanturi, evitând în acest fel unele situații poate neplăcute.

Will I be able to breastfeed after this kind of intervention?
With this technique, we practically do not touch the mammary gland, and the milk ducts (which carry milk to the nipple) are not cut.

So, this technique does not influence the milk function in any way. We have had countless cases where patients have breastfed after this technique without any problems, even after several pregnancies.

Which plastic surgeons practice this technique?
Not every plastic surgeon practices this underarm approach technique. Currently less than 1% of plastic surgeons practice this technique. Endoscopic axillary implant insertion requires special training and expertise on the part of the surgeon in addition to normal training.

Your plastic surgeon should have very good experience with all implant insertion techniques, either under the arm (through the armpit), under the breast or periareolar (around the nipple), to give you the best options and the best choice for your particular case.

Dr. Porumb Șerban has a great experience with all techniques, including transaxillary endoscopic, which he learned and practiced in America (USA) since 2002, being the first to introduce in Romania the full HD transaxillary endoscopic technique. He also holds a master's degree from the University of Paris XI, under the auspices of the Gustave Roussy Institute, entitled "Surgical Techniques in Carcinological and Reconstructive Breast Surgery", having a complete experience in breast surgery.

Even if I don't have anything inside my nose, why is my nose stuffy?
Since it is common after rhinoplasty surgery for the nose to be stuffy due to post-operative edema (swelling), this occurs both on the outside and inside of the nose, and will gradually disappear over time.

La ce să te aștepți după operația de Rinoplastie

  • Stuffy nose - It is normal after rhinoplasty surgery for the nose to be stuffy due to post-operative oedema (swelling), which occurs both on the outside and inside of the nose. However, the swelling will gradually disappear over time.
  • Secretions - In a day the nose normally secretes about 230 ml of mucus that runs down the throat without us being aware of it. After a nose job, due to the sensation of a stuffy nose, you may become aware of this normal discharge. You do not need to worry because of this. The combination of "normal mucus drainage" and "oedema-swelling inside the nose" may cause the drainage of secreted mucus to be on the nostrils and not posterior to the throat.
  • Headaches - Unfortunately, headaches are common after general anaesthesia and surgery. Please take only the painkillers prescribed by your doctor, and if necessary you may also be prescribed medication to improve your sleep.
  • Strange or unpleasant smell - A few weeks after surgery, you may notice a strange or unpleasant smell inside your nose as a result of mucus buildup inside. This is due to the reduced mobility of the "mucous blanket" inside the nose. As mentioned above, the nose secretes about 230 ml of mucus per day, which is pushed back by the mucus cells. After surgery, it will take between 4 and 6 weeks for the physiology of the nose to return to normal. During this period, you can clean the nasal mucosa by flushing with saline.
  • Bruises and swelling - Typically, swelling (oedema) and bruising peaks two days postoperatively. The good news is that a week after surgery, when the splint is removed, they will be much reduced so you can resume your social life.
  • Weaker smell - it is normal in the first week when you have the splints in your nose to smell weaker. It will return after the splints are removed, and so will the taste, as there is a connection between the two senses.
  • Swollen or numb upper lip- if your upper lip also swells a little and feels a little numb, this is normal after septoplasty. These symptoms are normal and will generally go away gradually in about 2-3 weeks after the procedure.
Why do I feel something leaking down my throat?
In a day, the nose normally secretes about 230 ml of mucus that runs down the throat without us being aware of it. But after a nose job, due to the sensation of a stuffy nose you may become aware of this normal discharge. You do not need to worry because of this.
Why do I have a discharge from my nostrils in the first days after surgery?
The combination of "normal mucus drainage" and "swelling edema inside the nose" can cause the drainage of secreted mucus to be on the nostrils and not posterior to the throat.
I have a slight headache and can't sleep, is this normal, what medication can I take?
Unfortunately headaches are common after general anaesthesia and surgery. Please take only the painkillers prescribed by your doctor, and if necessary you may also be prescribed medication to improve your sleep.
It's been 2 days since the surgery, why has the swelling and bruising increased?
Typically, swelling (edema) and bruising peak two days postoperatively. For this reason it is recommended to sleep with your head elevated and avoid salty or spicy foods and hot foods. The good news is that a week after the operation, when the splint is removed, they will be much reduced, so you will be able to resume your social life.
When can I wash my hair?
It is advisable to wait a week before removing the splint from the nose.
Can I clean the edges of my nostrils?
Yes you can clean the edge of the nostrils only on the outside, NOT inside, you can use Betadine and then saline, with the tip of a compress or with a cotton swab to clean the ears.
Why do I occasionally get a strange smell inside my nose?
A few weeks postoperatively you may feel a strange or unpleasant smell inside the nose due to the accumulation of mucus inside the nose as a result of reduced mobility of the "mucous blanket" inside the nose. As explained above, the nose secretes about 230 ml of mucus/day which is pushed back by mucus cells. After surgery, it takes 4-6 weeks for the physiology of the nose to return to normal, but in the meantime you can clean the nasal mucosa with saline washes as explained above.
It's been 6 weeks since the surgery, why does the nose still swell periodically?
The swelling in the nose decreases in two stages: the first stage is a swelling caused by fluid (fluid accumulation type oedema) that subsides in the first 3 weeks to 3 months. The second stage is a scarring remodelling inside the nose that occurs between the skin and adjacent tissues. The process takes place over several months and starts from the root of the nose towards the tip of the nose in a progression of 3-6-9-12 months and gets better with time, you should not worry about this.
When can you resume flying?
Flying can be resumed in about a week after removal of the nasal splint;
Is it normal for the skin of the nose to be numb?
The first 3-6 months after the procedure, the skin of the nose feels "numb", avoid exposure to extreme temperatures during this period, as sensitivity is diminished and you may risk sunburn or frostbite. Use sun hats and creams with SPF 50+ similar to those protecting children's skin during this period in summer.
Is it normal for my upper lip to be numb, swollen and even hurt my teeth?

Daca vi se umfla un pic si buza superioara si o simtiti un pic amortita , e ceva normal dupa interventia de septoplastie. Aceste simptome vor disparea in general progresiv in aproximativ 2-3 saptamani dupa interventie. Deci aceste simptome sunt normale si vor disparea progresiv.

Is it normal that I can't smell and the taste is gone?

Yes, it's normal in the first week when you have the splints on your nose. Smell will return after the splints are removed, and taste will return as there is a connection between the two senses.

Severe headache, fever, confusion, neurological symptoms
If you have a very intense and persistent headache, fever, can't stand the light, stiff neck especially when trying to touch your chest with your chin, vomiting, confusion, dizziness, or other neurological symptoms call your doctor or emergency department immediately, a complication requiring hospitalization is possible!

If you have questions or medical issues that have not been addressed above, it is important not to make decisions on your own. Please contact us by phone if you have any questions or schedule a specialist consultation with your doctor to get the right answers for your problem.

Do not hesitate to contact us:







    rinoplastie

    Rhinoplasty

    Closed, open, primary and secondary rhinoplasty, septoplasty (deviated septum correction), congenital cases.

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    Breast enlargement

    Transaxillary approach breast augmentation – breast implant inserted through the armpit without breast scars!

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    Breast lift

    Breast lift (mastopexy), with breast reduction or enlargement, ptosis and breast hypertrophy, tuberous breast.







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