Risks of Explantation of 500cc Under Muscle Silicone Implants Thru Areola? (photo)

I'm wondering if there will be deformity to my nipples, or the caved-in look from going thru the areola versus removal from under the breast, as they are rather large. I was an A cup prior to augmentation, 11 years ago. I'd prefer to not have the scar under breast obviously, but don't want to increase risk of poor outcome.

Doctor Answers 7

Removing breast implants in Los Angeles

I would suggest using the same incision used during the original implant placement. Combine the explanation with fat grafting if possible.

Dr. Karamanoukian 

Los Angeles Plastic Surgeon
4.8 out of 5 stars 94 reviews

Indentation after Periareolar Removal of Implants

   If the periareolar incision is closed in three layers, the risk of indentation is minimal.  The shape of the breasts will be compromised due to lack of native breast tissue and the long period of time the implants have caused stretching of those tissues.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Removal of Breast Implants and Deformity of Areola?

Thank you for the question.

Yes, there is a small chance that the nipple/areola complex will have a “caved in” appearance after removal of breast implants,  especially with the use of an infra areolar incision. If this is of major concern, then you may be better off using another approach,  such as the inframammary approach.  Avoidance of scars around the areola may eliminate one of the factors associated with the potential for a “caved in”  appearance of the areola postoperatively.

 Best to discuss your specific concerns with your operating plastic surgeon who will be in the best position to advise you precisely.

 Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,487 reviews

Explantation through areola

I think it would probably be best to use the incision at the bottom of the breast to eliminate any risk of areola deformity.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews

500 cc explantation

I think you might be focusing on something that may not be your top priority once the implants are removed.  I agree with the other doctors that using an IMF incision may help avoid tethering of the nipple due to scarring after explantation, but you might be unhappy with your breasts for a different reason than a scar.  Since you were an A cup many years ago and you do not look like you have gained a lot of weight since you appear to be very thin, your breasts are likely going to be quite deflated, with loss of volume at the top part of your breast, and probably loose skin.  Your breasts will not return to the state they were in 11 years ago, particularly after being stretched by implants for all this time, but also because your tissue has aged.   You may desire a breast lift to be happy with the shape and appearance of your breasts if you choose to not replace the implants, which will result in more scars than just the periareolar scar.  Please make sure that you understand all of your options and what the pros and cons are to each before you undergo surgery. 

Explantation of 500cc Under Muscle Silicone Implants Thru Areola

I see quite a few photos on this site of scar retraction after using the peri-areolar incision for explantation, that I would prefer to do this through the breast fold. Be aware that a change of this size may leave you wanting a breast lift in the future.

Thanks for your question, all the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

Removing implants

When you remove the implants they may cause puckering and you may not be happy without a replacement.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

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.