A significant portion of my revision patients travel to Honolulu from the mainland United States, and some from as far as the Middle East and Asia. They make that trip because endoscopic breast implant revision through the armpit is not widely available. Fewer than ten percent of plastic surgeons offer transaxillary primary augmentation, and the number offering endoscopic revision through the armpit is a small fraction of that.
If you are considering traveling for this procedure, here is what the process looks like from initial consultation to returning home.
Step 1: Virtual Consultation
Every out-of-state revision begins with a virtual consultation. This is a video appointment where I review your surgical history, current concerns, and goals. I will ask about your original procedure — the incision approach, implant type and size, plane of placement, and the surgeon who performed it.
If you have imaging (MRI or ultrasound showing implant condition) or operative reports from your original surgery, these are valuable and should be shared ahead of the consultation. Photographs from multiple angles are also necessary for assessment.
During the virtual consultation, I can determine whether your revision is likely feasible through the endoscopic armpit approach, what the procedure would involve, and provide a realistic assessment of expected outcomes. Not every case is appropriate for this technique, and I will tell you directly if I believe a different approach would serve you better.
Step 2: Scheduling and Pre-Operative Planning
Once we have agreed on a surgical plan, our office coordinates scheduling. For mainland patients, we typically recommend arriving in Honolulu two days before surgery. This allows time for the in-person pre-operative appointment, which includes a physical examination, final measurements, and confirmation of the surgical plan.
Pre-operative blood work and medical clearance from your primary care physician should be completed before you travel.
Step 3: Surgery Day
Endoscopic revision surgery is performed at our accredited surgical facility in Honolulu. The procedure is done under general anesthesia. Depending on the complexity of the revision, surgical time ranges from one to three hours.
All endoscopic revisions — implant exchange, capsulotomy, capsulorrhaphy — are outpatient procedures. You return to your hotel the same day with a companion to assist you.
Step 4: Recovery in Honolulu
I recommend staying in Honolulu for a minimum of five to seven days after surgery. During this time, you will have one or two follow-up appointments where I check your incisions, assess the implant position, and ensure healing is progressing normally.
The first two to three days involve the most limited activity. You will be able to walk, eat normally, and manage personal care, but should avoid lifting, reaching overhead, or strenuous movement. By day four or five, most patients feel comfortable with light activity and can enjoy gentle sightseeing if they choose.
There are practical advantages to recovering in Hawaii. The warm climate means comfortable lightweight clothing that does not press on sensitive areas. The relaxed environment supports rest. And many patients tell me they appreciated having a recovery period that felt removed from the demands of their normal routine.
Step 5: Flying Home
Most patients are cleared to fly five to seven days after surgery. I will confirm you are ready to travel before you book your return, and once you are cleared, flying at this stage is generally well tolerated. The cabin pressure changes in a commercial aircraft do not affect silicone or saline implants.
I recommend wearing a comfortable sports bra or compression garment for the flight, staying hydrated, and moving periodically during long flights to promote circulation.
Step 6: Follow-Up Care
After returning home, follow-up continues via virtual appointments. I typically schedule video check-ins at two weeks, six weeks, and three months post-operatively. Photographs are reviewed at each appointment to monitor healing, implant settling, and incision recovery.
If any concerns arise between scheduled appointments, direct communication with my office is always available. In the rare event that an issue requires in-person evaluation, coordination with a local plastic surgeon can be arranged.
Cost Considerations
Travel for surgery involves costs beyond the surgical fee: flights, hotel for approximately one week, meals, and the time away from work and responsibilities. For some women, this is a straightforward calculation — the value of avoiding a new breast scar is worth the travel investment. For others, the logistics are prohibitive.
Our office can provide referrals to nearby accommodations and assist with logistics planning. We work with out-of-state patients regularly and have streamlined the process to minimize friction.
Is Traveling for Revision Right for You?
If the revision you need can be performed by a qualified surgeon locally, traveling may not be necessary. If, however, you specifically want endoscopic revision through the armpit to avoid new breast scars, and no surgeon in your area offers this technique, traveling to a practice with established experience in this procedure is a reasonable decision. The technique is specialized enough that experience matters significantly for outcomes.