The axillary approach to augmentation mammaplasty produces no visible scar in the aesthetic unit of the breast. An endoscopic technique is recommended by some authors. 105 bilateral primary transaxillary submuscular breast augmentations were performed between 2004 and 2007. The dissection of the implant pocket after skin incision was performed strictly bluntly using the surgeon's finger cranially and a breast dissector caudally. Endoscopic instruments were in stand by for the first cases of the series but were finally never needed. All patients received textured silicon gel filled implants. Round implants with a moderate profile were used for the majority of the patients. Only 4 patients received high profile implants. The implant size varied between 225 and 500 mL. The patients were clinically followed up until 3 months postoperatively. 2 patients experienced a unilateral implant dislocation, one with a seroma requiring puncture and one further with a low grade infection which was managed by oral antibiotics. Only one patient required re-operation due to the complication, 2 others because they wished for a further enlargement of their breasts. 67 patients (64%) were recruited to assess the client satisfaction questionnaire - CSQ 8. The average score was 28.97±3.07 points (15 to 32 points, median 32 points). The transaxillary submuscular breast augmentation without endoscopic assistance avoids visible scars in the aesthetic unit of the breast, leads to a high patient satisfaction and low complication rate, not higher than for any other technique.