Can I Get New Implants w/ the Same Periareolar Scar? (Saline to Silicone Exchange)

I had breast surgery last year under muscle, under nipple with saline, if i want to redo will it be under nipple again? im afraid since i dont want more nerve damage as i already cant feel that much and i do want to breast feed one day. i was wondering if i can do it another way for less scarring? and less damage there again thanks!

Doctor Answers 19

Implant Exchange, Saline to Silicone from the Previous Incision

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It is very common for women to want to switch their breast implants from saline to silicone. In fact the majority of breast augmentations performed in my practice are silicone implants at this point because they give a much more natural soft feel.

Many women who are very thin and go with larger implants can have rippling or a firm feel and look to their implants. Many of my patients have been switched from saline to silicone to have a more natural appearance or decrease their rippling.

The surgery is very straightforward in comparison to the original breast augmentation. The muscle has already been stretched so patients do not feel the same pressure after their surgery. Patients are typically surprised how easy the recovery is for an implant exchange.

Changing implants through the previous incision is the most common way to perform the procedure. This prevents placing any new scars on the breast. Even if you have very small nipples it is a very straightforward procedure using the Keller funnel so that the silicone implant can easily be placed into the breast pocket from the nipple.

Implant exchange through the old incision

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It is possible to replace your breast implants through the periareolar incision, saline or gel. Sensation should not be affected working through the old scar. Our patients have little problem with breast feeding with the periareolar approach.

Best of luck,


Location of Incision for Breast Revision Surgery?

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Thank you for the question and picture.

Everything considered I think it would be in your best interest to have the revisionary surgery done through the same (periareolar)  incision.

Best wishes.

Implant exchange and periareolar complications

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If you are concerned about loss of nipple sensation, the implants can always be inserted via an infra-mammary approach. Although the circumareolar approach can heal beautifully, it does have the risk of loss of nipple sensation. I hope your plastic surgeon discussed all the possible risks and benefits of each surgical approach prior to your initial surgery. Generally, breast incisions heal well and I would focus on the issue of lack of sensation more than the incision, per se. Best of luck!

Breast Implant Scars

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For the reasons mentioned here, I use the original incision whenever possible. Best wishes!

Save yourself more scarring

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If you plan to have your implants revised, then you should have it done through the same incision. If you go through the same incision, there is little additional risk of nerve damage or inability to breast feed.

You can choose your breast augmentation incision

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If you want to exchange your implants, you can use the same incision or a new incision.  Just keep in mind that a new incision will leave a new permanent scar. Your best bet for silicone implants is to go through the peri-areolar scar (the one you currently have) or through an inframammary crease incision (one on the underside of your breast in the breast crease).

Same incision for redo Breast surgery is one of the options.

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There are a number of factors to consider with revisional breast surgery. Technically it is often very possible and practical  to use the old scar location to remove the old implants, modify the pocket as needed and replace with a saline or cohesive silicone gel implant. We try not to add scarring to the breast when possible. In some cases, a new scar in the breast fold may be recommended if:

  • the replacement implant will be too large to easily travel through the areolar incision.
  • the areolar incision from the first surgery has healed extremely well and you would not be accepting of a scar in the same place that may not heal as well. There is no guarantee that the second time through the area will result in as nice of a scar.
  • You do not want to disturb the nipple and areola further in order to reduce the risk of further loss of sensitivity or lactation function.
  • You and your surgeon may decide to use a highly cohesive or form-stable breast implant that will not easily go through the areolar approach.

Breast surgery scars tend to heal well and become discreet in any of the most common locations used.

Dr. Mosher

Incisions for breast augmentation

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The incision choice really depends upon the size of the implants being placed and the size of your areolas( that is, if you want to go back in the same way as before).  If not, an inframammary incision is fine.

Breast implants can be placed through the nipple, under the breast, or through the armpit.

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Breast implants can be placed through the nipple, under the breast, or through the armpit.

Usually, repeat surgery would be done through the same incision. But if you don't like the scar or the results, you can use another incision.i

Also, if you want to switdh to silicone implants, bigger sizes need bigger scars, which might be best through the crease under the breast.

None of these incisions should affect breast feeding in the future.

G. Gregory Gallico III, MD
Boston Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.