New technology minimisation

Sydney plastic surgeon Dr Darryl Hodgkinson explains the endoscopic technique for breast enlargement.

Endoscopic surgery, known as “bandaid” surgery due to the lack of scarring with this technology, has been successfully developed for use in breast augmentation surgery.

Endoscopic surgery is already well known for the tremendous advantages it has brought to patients in both knee surgery (arthroscopy) and abdominal surgery (endoscopic cholecystectomy). In plastic surgery, while the endoscope has been used primarily for brow lifting, mid facelifting and also tummy tuck procedures, it has now also found a place in breast enhancement surgery.

BEFORE and AFTER endoscopic breast enlargement by Dr Hodgkinson (actual patient – clinical photograph)
BEFORE and AFTER endoscopic breast enlargement by Dr Hodgkinson (actual patient – clinical photograph)


How the procedure is performed

The endoscope is a miniature camera which, when inserted through a small opening, enables surgery to be performed through a tiny passage – eliminating the need for large incisions.

In performing breast augmentations the endoscope is inserted through the

Incision site in belly button (actual patient – clinical photograph) umbilicus (belly button). A small, undetectable incision is made in the belly button, from which point tunnels are created up to and underneath the breast, through which the implant is passed.

A pocket is made for the implant using a balloon dissector (a specialised instrument) while ensuring, via the endoscope, that work is being carried out in the appropriate plane.

The saline implant, attached to a long filling tube, is then passed from the belly button through these channels to underneath the breast and placed in the pocket. Once in the pocket, the implant can be inflated to its appropriate size and sealed.

Who is a candidate?

Endoscopic breast augmentation does require special skills and experience on the part of the surgeon. In experienced hands, this procedure can lead to very nice results for patients who do not wish to have too large a breast size or who do not need a silicone implant. Only saline implants can be used for endoscopic augmentation mammaplasty.

The type of patient who often prefers a belly button approach using the endoscope may be a model, a woman who is a dancer or one who has a particular desire for no visible scarring.


As seen in the results shown, the belly button incision is totally imperceptible. This represents the most significant advantage as there is no scarring except in the umbilicus (belly button), which can be viewed as a “scar” or imperfection anyway.

The endoscope can also be used to assist in creating a pocket when the armpit incision is preferred. This, however, stills leaves a small scar in the armpit, as in the more traditional approach.

It is important to note that the endoscopic procedure cannot correct breast sagging in patients and one must be careful not to use too large a breast implant in an attempt to improve sagging.

I also use many other surgical techniques associated with augmentation mammaplasty with various incisions, using a wide range of breast implants.

About Dr Darryl Hodgkinson

Dr. Darryl J. Hodgkinson is recognized world-wide as an expert in cosmetic plastic surgery with more than thirty years of experience in both cosmetic and plastic/reconstructive surgery.

Dr. Hodgkinson did his plastic surgical training at the prestigious Mayo Clinic in the United States and is amongst an elite group of a very few surgeons to hold two degrees in plastic surgery from American Board of Plastic and Reconstructive Surgeons and the Royal College of Surgeons, Canada.

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