Breast implants in the nipple area and under the arm. My scars are so small you cannot notice them at all around my nipple area.

I have saline and it was place under the muscle and inserted around the areola nipple and it took a well for the feeling to come back to my breast. I want to know if I go larger can I go back and insert the larger implants in the same area as before? or will I have to choose another area to insert larger implants? I do not want to loose my feeling in my breast but the next area I will choose will be under the arm. I do not like the scars from under the fold of the breast. I have no scars now.

Doctor Answers 6

Can I go back and insert larger implants in the same area as before?

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Using the same incision again, especially if the healing was very good the first time around, would be our choice when you move up to larger implant. Areolar incisions work very well for both saline and silicone gel implants.

Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Same Incision Placement?

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It is always nice to use the same incision if at all possible.  It just depends on whether you have enough room around the nipple to fit a larger silicone implant through that access.  The best thing to do is to consult with a few board certified plastic surgeons and see what will work best for you.  I hope this helps.

Breast implants in the nipple area and under the arm. My scars are so small you cannot notice them at all around my nipple area.

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You may choose a different incision but since you already have one, it would make more sense to use the same one. An in-person evaluation would be best. See link below for examples

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 76 reviews

Incision site

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I like the under arm incision better. The silicone implants come prefilled and you will need a slightly bigger incision. Best is the under arm to avoid a scar on your breast

Lawrence Scott Ennis, MD, FACS
Pensacola Plastic Surgeon
5.0 out of 5 stars 162 reviews

Revision surgery for larger implant in the same pocket and through the same incision

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Thank you for your question.

You can definitely have the implant placed under the muscle (submuscularly) again if you have a revision surgery. In fact, you can also have the revision surgery through the same incision – periareolar incision. There should be less risk of losing sensation when working through the old scar and it would be in your best interests.

I would like you to note that loss of breast sensation is common when the implant presses up against the nerves. This is common with large implants . So it may be the case that you have already optimally filled out the breasts and going any bigger may harm the results. However, I could be wrong and an in-person exam would be needed.

Please focus on tissue-based planning – i.e., focusing on sufficiently filling your breasts to provide natural and aesthetic looking breasts rather than focusing on a specific cup size. This entails focusing on the long-term and not short-term results.  

Hope this helps!

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 521 reviews

Implant exchange

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Thank you for your question! If you have had previous implants placed through an incision around the nipple one should be able to go in through the same incision, as long as there are no circumstances preventing this. The benefit of saline implants are that it doesn't really matter how big you are going to go, the incision can always stay pretty small. This is because the implants are inserted in the deflated state and get filled once in the pocket. I don't perform breast augmentation from the armpit and have my reasons for it. Depending on how much larger you were wanting to go you may need revision of the actual pocket where the breast implant is. If this is the case you may need capsulectomies or capsulotomies to allow the pocket to expand and make room for the larger implant. Doing this through the armpit is difficult especially if one doesn't have a laparascope (camera). But the only way to really decide on where the incision would be best placed is by being evaluated in person.

As far as breast sensation goes....Anytime one has a breast augmentation they risk decreased or absent sensation to the nipple. The larger the implant the higher risk of this happening. This is because sometimes the nerves can get cut while trying to make the pocket bigger but more commonly the nerves can get stretched by the large implant. Hopefully you are being seen by a board certified plastic surgeon! Wish you the best of luck!

Ankur Mehta MD

Ankur Mehta, MD
Sugar Land Plastic Surgeon
5.0 out of 5 stars 25 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.