Isn't it too invasive to explant through a peri-areolar incision?

The periareolar incision should not cause inversion of the nipple.  It is not too invasive to use this incision.  Capsulectomy/capsulotomy should be decided at surgery.

The same incision should be used to explant your implants.  Your implants will be deflated right before they are removed so a smaller incision isn't a problem.  Unless you have capsular contracture causing you pain, the capsule shouldn't need to be removed.  Good luck

In general, unless there is a compelling reason why not, I almost always use the same incision to explant that was used to place the implants.  With saline implants this may be even easier, because you can actually deflate the implants either at any time under local anesthesia with a needle prior to removal, or you can simply pierce them at the time of surgery allowing the saline to leak out and then remove the empty shell.  In either case, because you are removing only an empty shell, there is only the need for a minimal exposure, and thus a small incision.  Additionally, unless there is some reason why it must come out, like it is excessively thick or contracted, I typically leave the capsule in place, and it usually shrinks and creates no further problem.  If we do need to remove the capsule, we can still do it through the periareolar approach, and in fact, that is usually easier for capsulectomy than the inframammary.  In either event, I have not had a problem using the original incisional scar for secondary procedures.  Good luck.

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.

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