I am considering getting saline again through the armpit, but am told that it's not possible? Is that true?

Question

Hello, I have had saline implant for 15 years. They still look fine, but I had a Transaxillary Breast Augmentation , and love that I do. It have scars. I am considering getting saline again through the armpit, but am told that is not possible? Is that true?

Daniel Barrett, MD · Answer

Dear Kat8890,
I tend to prefer the periareolar incision because its the most well hidden. There is a natural border between the areola and the rest of the breast skin the hides the incision extremely well. You have to be completely naked to see it vs other incisions like transaxillary and inframammary are visible in clothing such as sleeveless shirts and bikini tops when extending your arms up. I've also noticed increased rates of bottoming out with inframmary incisions that is not reported. Transaxillary implants are always wide in appearance because the surgeon is not able to dissect medially enough to provide better cleavage. Ultimately, I can perform any of the incisions but I recommend the periareolar. There is no difference in sensation because the nerves that control nipple sensation come in laterally from the back and injury to them occurs when surgeons dissect to far laterally which is why transaxillary incisions have the highest nipple sensation disruption. There is no difference in breast feeding ability. One study did show a slight increase in capsular contracture with use of periareolar but that study was small and did not incorporate modern techniques such as below muscle placement, keller funnel usage and triple antibiotic irrigation. 
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Gary M. Horndeski, MD · Answer

Yes, it is possible to remove your saline implants and place new saline implants through the axilla.

Best Wishes,

Gary Horndeski, M.D.

Connie Hiers, MD, FACS · Answer

The axillary incision is difficult to reuse, and most surgeon would not try it again. It also carries the highest risk for capsule formation.

I am considering getting saline again through the armpit, but am told that it's not possible? Is that true?

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