Incision Type for Breast Augmentation Revision

Hi. I had a BA and lift and then had many problems with my scar lines staying closed afterwards and had to have my implants downsized from 300cc to 250cc. In the future would it be possible for larger implants to be replaced, but through a different incision such as nipple or armpit, so that I did not risk having the same problems with pressure on my vertical scars from the lift. I have HP silicone implants at the moment.

Doctor Answers 15

Need a personal consultation

You need to be little more specific for reasons why the revision needs to be done.  What is your goal? In case of breast augmentation revision usually surgeon is going to try to use initial incision. You do not want to create, unless necessary a new incision and new scar tissue. The surgeon will advise you with the best option for the new procedure you require. There are times it is not going to be just a breast implant exchange, but patient needs a breast lift (mastopexy). In that case new incisions are required. You should arrange the consultation with your doctor to talk about the best options possible. These are decisions that can only be resolved during a personal consultation. Most likely axillary incision is not a good option in this situation

Chicago Plastic Surgeon
4.5 out of 5 stars 61 reviews

Using different incision for revision augmentation

In my opinion, your best bet is to stay at the size you are now. Trying to go to a larger size for you may prove too risky. Your soft tissue envelope may not allow this expansion.

Bhupesh Vasisht, MD
Voorhees Plastic Surgeon
5.0 out of 5 stars 86 reviews

Reaugmentation using a different incision.

From your brief description, it sounds your difficulty with wound healing was due to tension. The decrease in the size of the implant (albeit a small amount at 50cc) was performed to improved healing by taking pressure off the healing incision. This is a known issue with performing a lift at the same time as an augmentation - the goals of the surgery are counter to each other. The augmentation increases the breast size while the lift decrease the skin envelope. If not matched well, wound healing becomes an issue. As for a delayed reaugmentation with larger implants, it is safe to go through the previous incision if you are more than a year out. Using an alternate incision is also possible, but obviously leads to additional scars.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 25 reviews

Breast implant revision

Your problems after your surgery were major problems, requiring implant removal and replacement.  Honestly, if you have healed up and you look nice, I would leave well enough alone!  The enemy of good is better.  I have learned this the hard way. 

Lisa Lynn Sowder, M.D.

Lisa Lynn Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 73 reviews

Breast implant revision, breast uplift revision

Since you already have the scars from your uplift, almost any portion of it could be used to replace and enlarge the size of your breasts. I like to put the least amount of scars on my patients and would use one of the existing scars for revisions. Watch my videos and see my website for further info. 

Edward J. Domanskis, MD
Newport Beach Plastic Surgeon
4.4 out of 5 stars 27 reviews

Healing and Breast Augmentation

Healing and maturation of scars take up to two years biochemically. You can certainly change out the implants through a different incision. It will be hard to take out a gel implant through the underarm. Give your breast some time to heal and let the skin strech before you have another surgery.

Leo Lapuerta MD

Leo Lapuerta, MD
Houston Plastic Surgeon
4.2 out of 5 stars 47 reviews

Incision for revision breast augmentation

You need to have adequate time for the original incision to heal and the skin to adjust to your current implant. Generally, when the scars are no longer red, the scar is fully mature. Using the same scar for your revision is safe. After the skin has been cut once, the blood vessels in the skin dilate over a few weeks, making the wound edges more robust than when they were first cut.

Nia Banks, MD, PhD
Washington Plastic Surgeon
4.0 out of 5 stars 27 reviews

Wound healing problems from augmentations and now wants to go larger

You may be able to have larger implants inserted using the same incision. However, you did not indicate why there was such a problem healing in the first place. Were the implants too large for the pocket causing a tremendous amount of distracting forces on the incision? Was you skin very thin - combined with a tight closure? Medical problems? Etc.

More information would be required plus an examination to better make this determination.

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 30 reviews

Incision choice for revision

If you have an inframammary incision from your lift, I would wait a few monthys to be completely healed before considering going back for a larger size.  I would probably approach this from the inframammary incision.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Larger breast implants following breast augmentation with lift

Once your incisions are healed, you may increase the size of your implant to larger size as the breast lift incision lines have healed and are not at risk of falling apart; I would recommend you consider using the horizontal limb incision line as this approach may also allow you to correct the inferior breast pole which may have increased in size disproportionately, called buttoming out; this incision should heal well and not give you trouble as your lift incisions. You need to have your breasts evaluated by plastic surgeon to ensure appropriate approach is chosen for you.

Arian Mowlavi, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 67 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.