Can a ruptured silicone implant that was inserted though the armpit be replaced the same way? Or does it have to be the areola?

I had silicone 260g implants over muscle and had the incision for entry done under my arm pit. The doctor did a wonderful job. It's been 6 years and one of my implants has ruptured. I noticed a bump at the top of my right breast. It is not visible to the eye. I originally had them done in Germany and now that I am in America I cannot get the same implant so I would have to replace both to make sure they look the same. Is it possible to go under the arm again with a ruptured implant removal.

Doctor Answers 5

Implant exchange

No. It is probably better to have the implant removed through a more direct approach like inframammary to remove the implant and capsule if possible.


New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Replacing Ruptured Breast Implant

There are 2 parts to your inquiry. First, you did not say why you were replacing the implant other than that it was ruptured. By itself, this is not a reason to replace an implant. To do so you should be having symptoms like nodules, deformity or pain. Without these you do not need replacement. Secondly, if you do replace the silicone implant, though possible, I would not suggest doing so through the axilla. From there, there are 2 major problems. It is hard to get to the entire capsule to remove it, something that is frequently needed in replacing implants. Getting a new cohesive gel silicone implant in through the axilla is quite difficult requiring significant pushing and pressure on the implant which can cause micro tears in the shell that can later split and is one of the reasons that your implant may have ruptured. The most reasonable incision for this is inframammary as it makes removal of the capsule easier and can be made large enough to get the new implant in without excessive trauma to its shell.

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 5 reviews

Typically not a problem

you should be able to find a surgeon in south florida who has the skill and ability to go back through the same incision to remove the ruptured implant, remove the intact implant, and replace things. You may want to have some imaging performed to confirm the implant is indeed ruptured(MRI).

Yes you can!

Find a doctor who routinely does trans-axillary augmentations. I have done above and below the muscle arm pit incision augmentations for ten plus years. I have replaced gels and saline this way. The key is to find a doctor who knows how to do it using an endoscope or camera system. The blunt trans axillary approach is used by many but does not allow the doctor to see what they are doing. Good Luck!

Gregory T. Lynam, MD
Richmond Plastic Surgeon
4.9 out of 5 stars 53 reviews

Ruptured implant removal

Some surgeons will perform implant exchange through an existing axillary incision, but a more common approach is through the breast crease or around the areola. 

Before focusing on the incision, though, I wonder how you are sure your implant is ruptured. Without imaging, it can be difficult to determine whether what you feel is a rupture or a fold in the implant or even something related to the breast tissue itself. Even surgeons can't always distinguish rupture with physical exam. 

Since revision surgery has a higher risk of complications, I recommend seeing a board certified plastic surgeon who is experienced with the axillary incision and with revision cases. You can find physician names by searching on RealSelf or on the plastic surgery society webpage (asps.org). Best wishes. 

Dana Goldberg, MD
Jupiter Plastic Surgeon
5.0 out of 5 stars 32 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.