Second surgery same scar location? would I be able to have the surgery just replacing the old scar or do I need another location

The peri areolar approach used to be very popular because the scar was so well concealed. Although it is still performed today, in general most breast surgeons recommend the infra mammary approach because there is less risk of microscopic contamination and the development of capsule contracture. The IMF is also favored for secondary surgery because the visibility is better. Discuss with your surgeon as to which way he/she feels most comfortable.

I would never recommend putting a new scar on your breast or after you already have an old one. If there’s no need for a lift then use the same incision.

While there are reasons not to use the periareolar approach in many cases, it probably does make sense in your case rather than giving you an additional scar.