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A study of eight patients describes breast augmentation through the armpit using a single-port robotic surgical system (da Vinci SP). The authors report minimal, concealed scarring, no early postoperative complications and one revision surgery for implant displacement, and conclude that the technique is technically feasible. The authors themselves assign it level of evidence IV.
Robotic surgery is expanding into various fields, including breast surgery, but few studies have explored it in aesthetic breast augmentation. Traditional axillary breast augmentation relies on endoscopic assistance but is limited by restricted visualization, operational inflexibility, surgeon fatigue, and a long learning curve. This study introduces a robot-assisted transaxillary breast augmentation technique using the da Vinci single-port (SP) system, which offers high-resolution imaging with adjustable magnification, flexible robotic arms, and gas insufflation to reduce surgeon fatigue.
From January 2023 to July 2024, 12 breasts in eight female patients underwent surgery with this system. Four patients received bilateral augmentation for aesthetic purposes. The other four underwent direct-to-implant reconstruction after robot-assisted mastectomy, combined with augmentation of the opposite breast. The mean total operative time was 89.8 minutes (range 74-100), including a mean robotic docking time of 67.7 minutes (range 51-78). Intraoperative bleeding was minimal, and no early postoperative complications occurred. One patient developed lateral implant displacement and bottoming out and needed revision surgery. The authors presumably link this to mechanical stress from pectoralis muscle contraction during upper-body strength training in the early postoperative period. All other patients recovered uneventfully without late complications.
The authors conclude that robotic surgery overcomes the limitations of endoscopic techniques, with favorable cosmetic outcomes, minimal and concealed scarring, and greater surgical precision and safety. In their view, the study demonstrates the technical feasibility of a single-port robotic system for mammoplasty and shows its potential for other applications in aesthetic surgery. This is a study of eight patients, which the authors themselves assign level of evidence IV.
This is a technical feasibility study in eight patients, and few studies have explored robotic surgery in aesthetic breast augmentation. If you are offered breast augmentation through the armpit, ask your surgeon which technique they use (endoscopic or robotic) and how much experience they have with it. In this study, the only case that needed revision was linked to upper-body strength training in the early postoperative period. Ask your surgeon which physical activities you can resume, and when.
This content summarizes scientific publications and professional-society guidelines; it does not replace your surgeon's or anesthesiologist's evaluation. Every item links its original source.