Is it better to remove implants through the areola which is my original scar, or underneath the breast?

Yes, implants can be inserted through areola scars and of course, if your surgeon can remove the implants through the initial scar that will provide better visual results.

The incision used for implant removal can depend on your goal for the procedure. For removal of the implant only, a peri areolar incision can be fine. If you want the capsule removed, I usually recommend the incision under the breast. I do not remove implants under local anesthesia, but with a local anesthetic, the amount of breast tissue under the areola and where the least amount of dissection is required, could affect which incision is used.

The
removal of 300 cc implants will change the volume of the breasts significantly
creating sagging.  A loose skin envelope may
require skin excision.  For minor skin
excision, a circumareola approach is best. 
The implants can be removed through the incision and the skin can be
tightened.  If you need a greater skin excision,
you will benefit from an inframammary incision using The Bellesoma Method.  Best Wishes,Gary Horndeski, M.D.

For implants that have been in for several years, I would recommend removing the capsule with the implant.  This is better performed through an incision in your breast fold.  

If you are simply having the implants replaced, going back through the areola is possible so that you dont add new scars onto the breasts. If you are putting new implants in, i would suggest a new incision due to the risk of bacterial contamination of a new implant through the nipple and the risks of capsular contracture

Thank you for sharing your question.  Though nothing replaces an in-person examination of your tissues, your implants can be removed through your original scar.  If any ancillary procedures like a capsulectomy needs to be performed it may be better to have a new incision placed in your breast crease to avoid irregularities to your preexisting areolar incision.  Hope this helps.

You can have the implants removed through the original areola incision or under the breast.  As long as you are a candidate and the surgeon is comfortable with either approach, then the choice is yours.  Good luck with surgery!

Hi and thanks for your questionDon't worry about your implants having been placed through the areola- this was quite common, especially with saline implants. You could go either way with having them removed, but my personal preference, especially when removing them under local , is to make a small incision in the crease under the breast, I can usually get a saline implant out through a very small incision this way. The incision is more hidden, and there is more direct access to the implant as opposed to having to go down through more breast tissue to find the implant. In addition, periareolar scars can occasionally indent and stay more visible, so i prefer the crease if the patient accepts this.I hope that helps-

This is not a straight answer, as there are pros and cons.
First, I would recommend removing your capsule.  I saw some doctors said just to remove the implant, but if you do not remove the capsule, the tissue isn't "sticky" and the space the implant was in could persist.
PRO of using same scar: no new scar. easy access to the pocket for implant removal. The only real NEGATIVE:  I see is that occasionally you can get a puckering/indentation along that scar as there is no implant behind the scar to "push" it out.
PRO of using new scar: you don't have to heal the scar at the areola.  less risk of indentation there, and the scar is already faded. NEGATIVE: you are adding a new scar, and with a smaller breast if you do not have a definitive fold, you may see that scar.

I remove all implants through the fold because that is the best way to get control of the pocket where the implant sits to do the work.