Can a breast implant removal with a bilateral capsulectomy be done through the nipple instead of under the breast?

Question

Can a breast implant removal with a bilateral capsulectomy be done through the nipple instead of under the breast? I have small saline implants (210 & 230 cc's) under the muscle & plenty of breast tissue. One recently ruptured & I have capsular contracture (grade 2). The implants are 3 years old and my 2nd set. My first were silicone under the muscle in 2007 and I had the same issue with them feeling hard. Both sets were done through the nipple, so I want to avoid a scar underneath my breast.

Raffy Karamanoukian, MD, FACS · Answer

Removal of breast implants, intact or ruptured, may have positive implications if patients are symptomatic. A constellation of symptoms associated with breast implant illness, and autoimmune disease are considered when treating patients who have breast implants and are concerned about foreign body reaction. In our office, we begin this journey with a consideration of symptoms and exclusion of obvious autoimmune problems. In many of our patients, en bloc removal of breast implants with capsulectomy is important and beneficial. Further clinical evidence about breast implant illness is evolving and will continue to guide treatment. I would suggest removal if there is a possibility of foreign body reaction.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

M. Scott Haydon, MD · Answer

Thanks for your question. Technically a capsulectomy can be done through a periareolar incision if the diameter is adequate. The exposure required to do a capsulectomy is at least 5cm and sometimes this encompasses too much or the border of the areola that can lead to diminished sensation and even loss of blood supply. More importantly however the traction on the skin to provide exposure can injure the skin and lead to poor healing. Most of us would submit that a well healed incision in the crease is almost imperceptible whereas a bad scar on the edge of the areola is very noticeable. Best of Luck!

Earl Stephenson, Jr., MD, DDS, MBA · Answer

The simple answer is no you can not.  Removal of implants and capsules requires wider access to accomplish the necessary job.Dr ES

Robert E. Zaworski, MD (retired) · Answer

I would imagine that saline implants can easily be removed through a periareolar incision. Usually once the implant is located it is punctured, the saline suctioned out, and the deflated implant removed. Since your are not replacing your implants I see no reason to even perform a capsulectomy. Leave the capsule scar in place, over time it usually shrinks with no side effects.

Ronald V. DeMars, MD (Retired) · Answer

I would have to disagree with the previous consultant who said this can't be done as I have done the surgery through periareolar incisions for over 30 years. But the size of the areola has to be adequate. If the areola is quite small then this won't work.

Can a breast implant removal with a bilateral capsulectomy be done through the nipple instead of under the breast?

Answers (5)

Answer: Breast implant removal and capsulectomy via a periareolar incision.

Answer: Breast implant removal and capsulectomy via a periareolar incision.

Answer: Breast implant removal with a bilateral capsulectomy be done through the nipple

Answer: Breast implant removal with a bilateral capsulectomy be done through the nipple

Recommended reading

Everything you need to know about Breast Implant Removal

Our mission is to create a world where every investment in modern beauty is Worth It.

Can a breast implant removal with a bilateral capsulectomy be done through the nipple instead of under the breast?

Answers (5)

Answer: Breast implant removal and capsulectomy via a periareolar incision.

Answer: Breast implant removal and capsulectomy via a periareolar incision.

Answer: Breast implant removal with a bilateral capsulectomy be done through the nipple

Answer: Breast implant removal with a bilateral capsulectomy be done through the nipple

Browse related questions

Recommended reading

Everything you need to know about Breast Implant Removal

Our mission is to create a world where every investment in modern beauty is Worth It.