I had saline 270cc under the muscle 13 years ago, through peri-areloar incision, i'm wondering if it's best to use the same incision for the explant or if it will cause too much damage to cut again the breast tissue? is there more risk to develop an inverted nipple or that it is pulled inside with this incision? Also, can the surgeon know before the surgery if a capsulectomy is needed without seeing it from inside? Thanks
November 3, 2014
Answer: Periareola incision It really depends upon what needs to be done and the size of the areola. If the areola are large and a capsulectomy needs to be performed, it can likely be done through this approach. If any doubts an inframammary incision may be best.
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November 3, 2014
Answer: Periareola incision It really depends upon what needs to be done and the size of the areola. If the areola are large and a capsulectomy needs to be performed, it can likely be done through this approach. If any doubts an inframammary incision may be best.
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November 5, 2014
Answer: #BreastImplantRemoval - Isn't it too invasive to explant through a peri-areolar incision? No, not necessarily.Each case is different and there are very few absolutes. In general, though, if you're talking about implant removal alone, it's not unreasonable to use whichever incision was used to insert them, to remove them. It's advantageous to try to limit the scarring and using a different incision adds a new scar to each breast.The issue of capsulectomy makes it slightly more complicated because, in fact, an areola may be too small to allow for an adequate capsulectomy. In that case, a separate incision may be advisable (the patient should, of course, be seen for an in-person consultation before proceeding with the surgey). In general, though, if the areola was larger enough to allow the insertion of the implant originally, I would imagine that it would be large enough to allow for the capsulectomy.The last issue - retraction of the nipple - is harder to address. That can occur with any surgical procedure of the breast, and certainly including implant removal and capsulectomy. Though it may sound intuitive that a PA incision is more likely to cause retraction or deformity than an IM incision, I'm not aware of any scientific data that supports that. In fact, there are so many other factors - how thick the capsule is, how much breast tissue there is, how long the implants were in, overall BMI or thickness of subcutaneous tissue - that I think it would be difficult to limit the discussion to the incision itself.I hope that this helps and good luck,Dr. Alan EnglerMember of RealSelf100
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November 5, 2014
Answer: #BreastImplantRemoval - Isn't it too invasive to explant through a peri-areolar incision? No, not necessarily.Each case is different and there are very few absolutes. In general, though, if you're talking about implant removal alone, it's not unreasonable to use whichever incision was used to insert them, to remove them. It's advantageous to try to limit the scarring and using a different incision adds a new scar to each breast.The issue of capsulectomy makes it slightly more complicated because, in fact, an areola may be too small to allow for an adequate capsulectomy. In that case, a separate incision may be advisable (the patient should, of course, be seen for an in-person consultation before proceeding with the surgey). In general, though, if the areola was larger enough to allow the insertion of the implant originally, I would imagine that it would be large enough to allow for the capsulectomy.The last issue - retraction of the nipple - is harder to address. That can occur with any surgical procedure of the breast, and certainly including implant removal and capsulectomy. Though it may sound intuitive that a PA incision is more likely to cause retraction or deformity than an IM incision, I'm not aware of any scientific data that supports that. In fact, there are so many other factors - how thick the capsule is, how much breast tissue there is, how long the implants were in, overall BMI or thickness of subcutaneous tissue - that I think it would be difficult to limit the discussion to the incision itself.I hope that this helps and good luck,Dr. Alan EnglerMember of RealSelf100
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