Background: Subfascial endoscopic transaxillary breast augmentation were reported the benefits over the submuscular implant since 2000. Long term outcome was not reported in any large number of cases.
Objective: To evaluate the long-term outcome in 3,004 cases over 10-year period.
Methods: From 2007 to 2018, 3,004 cases were operated in our center. 2,949 cases undergo subfascial endoscopic transaxillary breast augmentation with textured round implant, 35 cases with smooth round gel, and 20 cases with textured anatomical implants. Inclusion criteria for patient selection is the pinch test in all patient group and this value is more than 1.5 inch. Post-operative follows up time from 2007 to 2018 with yearly visit with postoperative photograph. Postoperative complications were evaluated by the capsular contracture, abnormal chest muscle movement, rippling, infection, seroma, bottom out, hematoma, implant rotation and implant border palpation.
Results: Early postoperative hematoma was found in 0.16% in textured round implant and was not found in smooth gel and anatomical textured implant. The rate of capsular contractor was 0.16% in textured round implant, 20.0% in smooth gel and 10.0% in anatomical textured implant. The rate of infection and seroma formation occurs 0.2% in textured round implant. The rate of rippling is 0.33% in textured round implant, 10.0% in anatomical textured implant and no rippling in smooth gel implant.
Conclusion: Subfascial endoscopic transaxillary breast augmentation can be used in patients with thick breast tissues. Rippling and implant border palpation occurs frequently in textured round implant and textured anatomical implant. Capsular contracture is noticeably high in textured anatomical and smooth round implant. Careful selection of the patients is the key to success in this type of breast augmentation.

Keywords: breast augmentation, endoscopic, late complication, rippling, sub fascial, textured round implant

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