Breast Implant Revision: Q&A

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Was Told by My Surgeon that a Second Armpit Incision to Replace Implants was not an Option, Is this True?

I am considering replacing my implants - done thru armpit incision - with slightly larger ones, but was told by my surgeon that a second armpit incision is not possible. Is this true and why?

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armpit options transaxillary

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11 Doctor Answers | Asked by Marierl

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Was Told by My Surgeon that a Second Armpit Incision to Replace Implants was not an Option, Is this True?Answer:

I have used the underarm incision for more than 10 years and I almost always use the endoscope and use it to replace implants all the time...I use the Keller Sleeve if I am doing gel implants greater than 400cc...It is a great approach, but I do think that using the endoscope is crucial...

Transaxillary incision for replacement implants

I tend to agree with your surgeon's recommendation. If you use the inframammary or areola incision, the physician is directly at the surgical site. Therefore, he/she have complete control and total visibility. The underarm incision is further away and can't correct any shape issues etc.

Second arm incision for implant revision/exchange

Depending on what is done with your revision surgery, it may be difficult to impossible to do through the arm pit incision. The "work horse" incision in the inframammary fold allows more direct access and is needed in most revision surgery. Donald R. Nunn MD Atlanta Plastic Surgeon.

Donald Nunn, MD, DDS

3 reviews

Atlanta Plastic Surgeon

Breast Implant Revision Through An Armpit Approach

With a transaxillary approach to your first surgery, you undoubtably have saline implants. While it is possible to replace your existing implants through the old incision with an endoscope it is difficult, particularly if the pockets need adjustments. If it is just an implant replacement with no pocket modification, then it is less difficult. Regardless of what is needed, revising your implant is easier on both the surgeon and your recovery if you consider changing to a lower inframammary... more

Transaxillary revision

It is sometimes difficult to redo implant surgery through the armpits because of limited visibility of the pocket. If using an endoscope it may be possible.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Replacing implants through transaxillary incision

The transaxillary approach is not optimal if the breast pocket requires revision or you have developed capsular contractors. Of all the incisions, this is the "blindest" approach to the breast and the risk of complications in an implant exchange would be higher as a consequence than with the inframammary or circumareolar approaches.

Revisionary Breast Surgery Approach?

Thank you for the question. Generally, this removal and replacement of breast implants is all that is planned that it can be done through any approach. However, if additional work as planned (for example, adjusting the breast implant pockets and/or removing scar tissue) than the trans axillary approach may not be the best approach to use. Assuming your surgeon is well experienced with the visionary breast surgery you may want to ask him/her about the reasoning behind... more

Possible does not always mean it's in your best interests

Hi there- I'm guessing here, as I obviously don't know you or your surgeon, but... I think what your surgeon was trying to say to you is that, in his hands, and given your particular set of circumstances and goals, it would not be advisable to try to do your operation using another armpit approach. This doesn't mean it can't be done. Just that he doesn't think it's the right way to go.

Transaxillary incisions

My article on over 1600 transaxillary augmentations (the largest series to date) was just published in the Aesthetic Surgery Journal in September of 2011, which is the official Journal of the American Society for Aesthetic Plastic Surgery. About two thirds of the time, I was able to go back through the armpit incision for any revision needed. The times where that is not possible is if there is a capsular contracture bad enough that you have to remove part or all of the scar... more

Dan Mills, MD

10 reviews

Orange County Plastic Surgeon

www.danmillsmd.com

More information about the reason for exchange

If you have silicone gel implant and your surgeon is concerned about the implant leakage or there is a need for the implant pocket revision, then transaxillary incision is not a good option.

Kamran Khoobehi, MD

28 reviews

New Orleans Plastic Surgeon

Replace Breast Implants through Armpit Incision

Without knowing more about your situation, it is hard to say why the implants can't be replaced through the same incision. If the only thing that needs to be done is replacement, then it may be possible. If other things need to be done (capsulectomy, pocket revision, etc) then it may be better to use a different incision. Ask your plastic surgeon for more details or consider a 2nd opinion.