Can I do an areola incision for breast implant exchange? After having previous inframammary incision (Photo)

Dear evangeline jamie,
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

It is very well known that periareolar incisions lead to higher rates of capsular contracture, and other scar related deformities like scar tethering. Your surgeon placed the incisions in your inframammary fold for a good reason. Now in revision surgery, the reason is even more salient. Don't make a bad mistake.

Hello, I am Dr. Salvador Garcia, Yes, the implant can be performed through the areola by doing an internal bra and changing the implants.

The areolar incisions could be made, but do not go larger. You are bottoming out now with the weight of these implants. Going larger will thin your own tissue even more and be heavier with more risk of sagging again. You need to go smaller and have your inferior pockets lifted and tightened.