I got my current implants in 1995 and am having no problems, but they are starting to sag more than I would like. They are under the muscle and were inserted through my armpit. If/when they need to be replaced, can I go under the arm again? I like the idea of having no visible scars...and my nipples are already almost completely numb, so I dont' want to risk any further loss of sensation.
When Replacing Implants Can I Go Under the Armpit Again?
Doctor Answers (8)
Replacing Breast Implants through pre-existing Armpit Scrs
Revisions through armpit incision are very difficult
Since many patients over the course of their lives will require an additional procedure, and it cannot typically be done through the armpit incision, I am not a fan of that approach. You will end up with another scar anyway. Correction of sagging for example cannot be done though the armpit.
Replacing implants through armpit incision: difficult to correct sagging (ptosis)
If you plan on replacing implants through your existing armpit incision, it may be difficult to correct sagging (ptosis)
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Placement of incisions aesthetically has little ramifications in breast augmentation.
Revisions through the axilla are more difficult because breast is somewhat remote, but it is not impossible. I use all three approaches at the patient's request. I don't see much difference when the scars remodel. There is a lot of lip service paid to placement of the incision, but in the end, I don't think it makes much difference,
Breast Implant Revision Through the Armpit
The only advantage of going through the armpit is that there are no incisions placed on the breast. However, this initial advantage is usually lost when it comes to breast implant revision surgery. The only reason to go through the armpit again is if you just want to change out the implants. If there is any sagging or droopiness to the breast, then going through the armpit will not work.
In fact, you will trade one problem for another. Typically when a woman needs a breast lift and just has implants placed, it results in something we call "Snoopy" deformity, named after the cartoon dog. This is because the breast tissue falls off the implant and it looks like Snoopy's head in profile. If you really need a breast lift, there is no way to avoid incisions on the breast. Now the amount of incisions you need, whether it's just around the areola, a lolipop, or an upside T incision, depends on 2 things: 1) How low your nipples are and 2) How loose the skin is.
Transaxillary breast aug
If you are only wanting the implants replaced, going through the armpit is fine. However, new scars will be necessary on the breast if you also need a lift.
Breast implant revision for sagging breasts through the arm pit
If you have sagging breasts then a revision will most likely require a lift of some sort. This will unfortunately add an incision on the breast.
Can you revise breast augmentation through the armpit?
While the trans-axillary approach is great for avoiding incisions to your breast, it is not so great in the long run if you need a revision. And, given the fact that a majority of women will revise their augmentation at some time, the need for either a IMF or peri-areolar incision then arises. If your breasts are less perky now, you could potentially add more volume through a larger implant or you may need a breast lift. Either way, you will most likely need an additional incision to perform this revision.
I hope this helps!