Typical incision
About 3–5 cm
Minimally Invasive Surgery
Endoscopic Breast Surgery
A considered approach to hidden incisions and thoughtful reconstruction
Optimized operating time
About 1–2 hours
Main access route
Axillary fold
Start with the essentials
What Is Endoscopic Breast Surgery?
Endoscopic breast surgery uses a magnified high-definition view to remove breast tissue through a small incision in a discreet area such as the armpit. The incision is usually placed in a natural axillary fold, so the breast surface generally has no surgical incision.
Its central change is the surgical route: after planning appropriate oncologic treatment, the team aims to reduce visible breast scarring and may perform reconstruction at the same time or in a later stage, depending on the patient.
Whether an endoscopic approach is appropriate depends on the lesion, stage, breast anatomy and previous surgery, and must be assessed by a breast surgeon.
Prepectoral endoscopic reconstruction animation
Play to see the endoscopic reconstruction route
Minimally Invasive Surgery
Key Advantages
Hidden Incisions
Incisions sit in natural skin folds, invisible at a glance
Precise Resection
Endoscopic vision delivers clear, accurate removal
Faster Recovery
Less pain and a shorter stay, quicker return to life
Aesthetic Result
Less visible breast scarring, preserving a natural appearance where possible
Technical approach
Making a discreet incision serve safe, precise work
Non-liposuction gland excision
The gland is separated and removed under endoscopic vision without a liposuction step, while preserving appropriate flap thickness and blood supply for reconstruction.
Reverse-sequence endoscopy
The operative sequence is adapted to local anatomy to reduce unnecessary dissection and repeated instrument movement, helping control time and complexity.
Single-incision port design
Planned camera and instrument angles, including the Huaxi No. 1 and No. 2 ports, allow coordinated work through one axillary incision with fewer additional punctures.
Procedure range
The procedure follows the patient's condition
These are procedure directions described in the source material. The actual route, resection and reconstruction plan must follow the team's assessment of the examination results.
01
Endoscopic breast-conserving surgery
Remove the lesion and surrounding tissue with a safe margin while preserving as much breast contour as possible.
02
Endoscopic implant reconstruction
Place an implant after gland removal to restore the breast contour, either immediately or in a later stage.
03
Endoscopic subcutaneous gland excision
Remove the subcutaneous gland under endoscopic vision while maintaining suitable flap thickness and blood supply.
04
Unilateral reconstruction with contralateral augmentation
Reconstruct one side while improving the shape of the other, after assessing body proportions and goals.
05
Endoscopic prophylactic resection and reconstruction
For selected high-risk situations, discuss a preventive resection and reconstruction plan.
06
Endoscopic benign lump removal
Remove a suitable benign lump through a discreet incision; the route depends on its size and location.
07
Immediate or staged implant reconstruction
Complete implant reconstruction in one or more stages to allow tissue recovery and contour adjustment.
08
Endoscopic injectable-material removal and reconstruction
Remove previous injectable material or related foreign bodies, then discuss reconstruction based on the tissue condition.
09
Reduction mammoplasty
Adjust breast volume and shape when indicated, with a plan designed by a specialist team.
Reconstruction choices
Reconstruction deserves the same careful discussion as resection
Implant reconstruction
Under endoscopic vision, the team prepares the space behind the pectoral muscle or beneath the skin, places the implant and adjusts position and symmetry. It is generally shorter and suits patients with adequate soft tissue coverage.
Often considered when: the patient wants a shorter reconstruction pathway and the chest-wall soft tissue is suitable.
Autologous tissue reconstruction
Use a flap or fat tissue from areas such as the abdomen or back to rebuild the breast. It may reduce obvious scars at the donor and recipient sites, but usually requires more time and technical expertise.
Often considered when: an implant is unsuitable or the patient prefers their own tissue.
Surgical journey
From assessment to post-operative observation
- 1
Assessment
Define the lesion and plan the access and reconstruction
- 2
Anaesthesia and position
Usually general anaesthesia, supine with the affected arm abducted
- 3
Create the access
Build the endoscopic working space through the axillary fold
- 4
Gland excision
Remove the gland while paying attention to flap blood supply
- 5
Reconstruction
Place the implant or transfer autologous tissue as planned
- 6
Drain and close
Place the drain, close in layers and begin observation
Understanding the approach
Endoscopic access compared with open surgery
Incision
Traditional open surgery：On the breast surface and relatively longer
Endoscopic breast surgery：In the natural axillary fold, commonly about 3–5 cm
Scar location
Traditional open surgery：May leave a more visible breast scar
Endoscopic breast surgery：Usually no breast-surface incision; the scar is more discreet
Surgical view
Traditional open surgery：Direct view
Endoscopic breast surgery：Magnified endoscopic view with clearer tissue planes
Operating time
Traditional open surgery：Varies by procedure and extent
Endoscopic breast surgery：Can be optimized to about 1–2 hours, but still varies by patient
Tissue trauma
Traditional open surgery：May involve a wider area of tissue separation
Endoscopic breast surgery：Minimally invasive access may reduce surface trauma
Contour and appearance
Traditional open surgery：Contour can be restored, but the breast scar may be more visible
Endoscopic breast surgery：Aims to preserve the breast surface and natural appearance
Technical requirements
Traditional open surgery：Established technique with a shorter learning curve
Endoscopic breast surgery：More demanding and requires dedicated training and teamwork
Indications and boundaries
One access route is not right for every patient
Factors usually assessed
- Want to balance treatment, a discreet incision and breast contour
- No skin invasion and breast anatomy suitable for endoscopic access
- Imaging, pathology, body habitus and prior surgery support the plan
When open surgery may be preferred
- A large or locally advanced tumour makes a safe margin difficult
- Skin involvement or a need for a more extensive resection
- Severe adhesions from previous surgery make the space difficult to establish
Safety and recovery
A safe process matters more than the incision alone
Safety depends on a standardized operation, thorough assessment and peri-operative care. Selected patients may leave within 24 hours after a short period of observation if no concern is found.
After surgery, follow instructions for the incision, drain and arm movement, progress through rehabilitation gradually and attend scheduled reviews.
Contact the hospital promptly for ongoing bleeding, marked redness or fever, worsening pain or unusual drainage. Do not manage these signs alone.
This page is for general health education and is not a diagnosis or surgical recommendation. Indications, technique, reconstruction and recovery time must be assessed by the breast and anaesthesia teams using your examination results.