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Should I Replace my Saline Implants with Silicone Through Nipples or Under the Breast?

asked 1 year ago by Zagreb in Zagreb, 21
Latest answer by Richard Linderman, MD
Question viewed 1,291 times
Tags: saline implants, silicone implant, choices, inframammary, periareolar, placement, replacement

I have saline implants for 7 years, through my nipples, and want to replace them with silicone. But one doctor wants to go under the breast instead of through the nipples. He says it's easier and better that way, and that the silicone won't fit through the nipples Another doctor wants to go through the nipples again. Please advice which way is best. The original way through the nipples or under the breast.

20 answers to Should I Replace my Saline Implants with Silicone Through Nipples or Under the Breast?

Best Replacement Incision

Hello, There is no one best access incision for every person, and it should be considered individually. The factors involved to determine which on is best for you are numerous including skin type, breast shape, and your preference among others things. Additionally, some surgeons, including myself, have reservations about certain places for incisions because of concern for bacterial contamination and capsular contracture. In your situation, you already... more

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon

drminniti.com

Breast Implants Replacement Through The Nipple

I would suspect you are having your implants replaced because of the feel or rippling. The choice of the incision is purely a personal preference of your surgeon. If the implant is large and your areolar incision is small, the using an incision under the breast might be better. If possible I would try to use your old incision unless you have a history of capsular contracture.

Richard Linderman, MD
Indianapolis Plastic Surgeon

Implant replacement thru the nipple or beneath the breast

As someone who gets referred a lot of revision breast surgery, I'm going to disagree slightly with my colleagues and suggest that revision thru the periareolar incision with gel devices can be significantly more difficult a procedure, particularly with larger devices. Unless the patient is getting some kind of associated periareolar mastopexy, the precision of the IMF approach (particularly for retropectoral implants) is going to be superior for this and produce less potential... more

Robert Oliver Jr., MD
Birmingham Plastic Surgeon

Silicone Breast implant augmentation surgery through nipple or crease

These recommendations are typical of differences in opinion and there is no right or wrong answer. Do you like Coke or Pepsi? Why? Some people believe that going through the nipple potentially adds bacterial contamination and biofilm formation. However it is generally a better scar. IT is a trade-off in any case.

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Re-augmentation

Generally speaking, plastic surgeons always try to make use of pre-existing scars. However, since a silicone implant is being inserted in this case, if your board - certified plastic surgeon feels that the incision would be too small or is worried about stretching the tissue or decreasing sensation to the nipple, then they may advise to put the scar under the breast.

Samer W. Cabbabe, MD
Saint Louis Plastic Surgeon

Incision for revision breast augmentation

As you are aware, there are multiple ways to do a breast augmentation and every surgeon has there preferred approach. For a revision, it is most aesthetically pleasing to go through the original incision so you do not have two scars on your breast. As long as your original periareolar incision healed well, I would recommend staying with that approach. I hope this helps in your decision. Kindest regards, Neil J. Zemmel

Neil J. Zemmel, MD
Richmond Plastic Surgeon

Silicone Incision Point

I would use the Keller Funnel device and with that you can fit the Silicone implants thought the areola incision if desired or through the armpit incision.

Robert N. Young, MD
San Antonio Plastic Surgeon

www.dryoungforever.com

Incision choice for breast augmentation with silicone.

The decision to use periareolar (around the nipple) incisions for breast augmentation with silicone implants depends on the diameter of the areolas and the size of the implants. Silicone implants require a larger incision in general than saline. This is because the saline implant is placed into the breast, then inflated. I feel that if I can place the implants through the previous scar without making a new incision, that is the better option.

David Bogue, MD
Boca Raton Plastic Surgeon

www.drbogue.com

Replacement of silicone implants through nipples or under the breasts

The decision to replace saline implants with silicone is a common one. The choice of incision is dependent upon many variable. The first should be a question of the pre-existing incision. All attempts should be made not put any additional scars of the body.

Peter D. Geldner, MD
Chicago Plastic Surgeon

www.mygeldnercenter.com

Breast implant replacement incision options

I generally utilize the same incision from the original augmentation when changing implants. The only limiting factor in your case would be if your nipple areola was very small in diameter, then the old periareolar incision may not be large enough to accommodate placement of the silicone prosthesis. Because the saline prosthesis is inflated after placement a smaller incision is made than would be with silicone prosthesis.

William F. DeLuca Jr, MD
Albany Plastic Surgeon

www.delucaplasticsurgery.com

Generally, Breast Implant Replacement is Through the Original Incision

In general, breast implant revision or replacement is done through the previous incision. In your case, this would be an areolar/ nipple incision. There is a slightly increased risk of capsular contracture through an areolar incision, due to a slightly higher bacterial contamination count through the areola versus the breast fold or underarm incision. Your old incision should be big enough for pretty much any silicone breast implant. If your plastic surgeon is balking... more

Roy Kim, MD
San Francisco Plastic Surgeon

Incision placement for breast implants

Implants can be placed through several different incisions. Sometimes if the areola are small, they may not accomodate a silicone gel implant which is always pre-filled. Saline implants have the luxurtry to go through a smaller incision because they can be rolled up.

Steven Wallach, MD
Manhattan Plastic Surgeon

Use previous incisions for breast implant replacement

Unless you have extensive capsular contracture that requires capsulectomy- your removal and replacement will be best done using your existing peri-areolar scar. I recommend IMF incisions in patients that require extensive capsular work in removal-replacement cases.

Scott Sattler, MD
Bellevue Plastic Surgeon

The best way for silicone

Both are possible. The best way for silicone, in my opinion, is by an incision under the breast; however, if you have an incision around the areola, then going through this incision would save you an additional scar.

Shahin Javaheri, MD
San Francisco Plastic Surgeon

Exisiting Scar Usually Preferred For Change of Implants

In general, most surgeons prefer to go through an exisiting scar unless there are mitigating circumstances, In general, even with a small areola, a surgeon should be able to get up to a 500cc silicone implant in through there. It is a little more work, but if your existing scar healed well and you are happy with where it is at, then I would attempt to go through the same placement. I hope this helps.

Christopher V. Pelletiere, MD
Barrington Plastic Surgeon

A nipple of 4 cm diameter gives an incision of 6,28 cm

As a nipple (areola) has an average diameter of around 4 cm (1.57 inch) an incision of half the circumference has a length of 6,28 cm (2.47 inch). This is longer than the average incision which is used in the fold under the breast, and usually doesn't exceed 2 inches. This means that unless you have a nipple-areola of less than 4 cm placing a silicone implant of a "normal size" (less than 400 cc) should be feasible.

Alexis Verpaele, MD
Belgium Plastic Surgeon

Periareolar or inframammary incision for silicone breast aug- which is better?

Either the periareolar (around the lower half of the areola, along the edge of the colored skin around the nipple) or the inframammary incision (along the crease under the breast) are effective incisions. There is a slightly increased risk of capsular contracture and infection using the periareolar incision according to a few clinical reports of published case series, but there are no randomized properly controlled studies published on this. Either incision is good and useful in... more

Claudio DeLorenzi, MD
Toronto Plastic Surgeon

Implant replacement incision

As long as there is enough room to fit the gels in through your previous incision, I would just do that.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Replacing your saline implants

It may be hard to believe this, but there is no one best way to do anything, especially in cosmetic surgery. When it comes to a situation similar to yours, I have done it both ways: either through the original scar near the areola and through an incision in the crease. The answer depends on many different factors, including your individual anatomy, the size of the implants, surgeon preference/experience, etc. An in-person consultation with a surgeon you trust will hopefully... more

Allan J. Parungao, MD
Oak Brook Plastic Surgeon

Breast Augmentation Incision Options

Your questions is a really good one-- which is the better option in terms of incisions for breast augmentation. The short answer is that either approach can give you a nice result-- both incisions can give you a nice result and most plastic surgeons feel comfortable with either approach. But in your case I would just use the incision you already have instead of giving you another scar.