Armpit approach for implant exchange? (Photo)

For the best result I recommend using the incision in the inframammary fold. This allows your surgeon to visualize the space and seat the implant properly. It makes sense since you already have the incision. Treatments can be started early to encourage favorable scar healing.

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

Your scars are healing very nicely. I am not sure how far out you are from your procedure, but scars can take up to a year to fade and augmentation scars are often imperceptible once mature. Only saline breast implants can be placed via an axillary approach (through the armpit) and this would leave additional scars. To avoid placing any additional scars, I would use the scar that is already present regardless of attempting to lower the scar to the fold. Attempts at recreating a fold can also be accomplished internally without additional scarring on the breast. Additionally, you'll want to keep in mind the diameter of your chest wall and skin stretch when considering a larger breast implant, as these can be limiting factors. Ultimately, I would make sure you're going to a board certified plastic surgeon and discussing all of your concerns to get the best possible outcome.