Breast implant replacement through the axillary incision
There is no question that you could change out your saline implants with silicone implants through the axillary incision. I do it every week.
You have to find someone who specializes in this approach, as most plastic surgeons do not feel comfortable with this incision, so they love to poo poo this approach. The facts are that I have done about 2,000 breast augmentations over the last 20 years, and have replaced 76% of the implants back through the armpit incision when needed.
The only times that this is not able to be done in my practice, is when you have to remove a portion of the capsule (scar) from around the implant (capsulectomy). You have to be able to see to disect between the capsule (scar) and the normal tissue, which is impossible through the armpit.
So for capsulectomies, you have to use another incision like the areolar or inframamary incision as much as it pains me. You just have to find someone who is expert at the transaxillary incision.
Don't give up. Good luck.
Replacing Implants Through The Armpit
It is technically possible to replace implants through an armpit incision, whether the implants are saline or silicone.
Capsulectomy (removal of the old breast implant capsule is not feasible through the armpit: if you require capsulectomy, an areola or breast crease incision is necessary.
Axillary Incisions for Breast Augmentation
I agree that except for very large implants it should be possible for an experienced surgeon to replace your saline implants through an axillary incision. As the other physicians have noted the challenge come from your capsule.
To get the capsule out completely you may require an areolar (below the nipple) incision or an inframammary incision (in the breast fold).
I hope this helps.
The size of the new implants will determine whether this is possible.
An axillary approach for silicone implants is limited because large implants require an incision that is too long to hide in an armpit location.
The vast majority of women who seek reoperation in my practice do so to go to a larger implant size. That means that I am usually placing implants that are 400 cc or larger in the patients who are second-time implant seekers. This size can not be comfortably placed through an axillary approach. I prefer to use a fold approach for these larger implants.
I have found that struggling to place a silicone implant through an incision that is too small invariably leads to a poor scar from the trauma of the insertion. It is far better to have a slightly longer scar that heals well than a shorter one that suffered the trauma of trying to push an implant that was too big into that scar.
I prefer not to put in silicone implants via the axillary (armpit) approach, although it can be done. Too much distortion of the muscle and a large incision are required. I prefer to only put in saline implants via the axillary. If you have firm or hard breasts or capsular contractures, you are not able to perform capsulectomies via the axilla and will need it to be performed via the periareolar or inframammary approaches. Why are you adverse to the other approaches?
Depends on the size and the reason
Your saline implants can indeed be replaced with silicone implants through the armpit (axillary) incision. However, you will be limited in the size of implant that can be inserted (maximum 350-375cc) and by your need for work on the capsule. If your breasts are currently soft with no capsular contracture, then minimal or no capsular work needs to be done and the replacement can probably proceed through the armpit. Good luck!
It all depends on your anatomy
Huy, Implants can be placed through the axillary, areolar or inframammary fold incisions. However, choosing the incision site really depends on your anatomy. If you need extensive capsule work done, then the areolar or inframammary incision is probably the best choice. Remember not to compromise your results by trying the hide your incision. All three choices for incision sites tend to heal very well. I hope you find this helpful. David Shafer, MD New York City
Areola or crease would be better
The crease is the easiest way to do breast revisionary surgery followd by the areola. It would be technically difficult through the armpit and probably not in your best interest.
Reoperation through armpit
It would be possible but technically difficult and time consuming to remove the capsule and the old implants through an armpit incision using an endoscope. The operative time would be much greater than for a direct approach underneath the breast or around the areola.
A much more direct and safer way would be through an existing incision around the areola or underneath the breast.
Implant Exchange through the Armpit
It is very common for women to want to switch their breast
implants from saline to silicone. In
fact the majority of breast augmentations performed in my practice are silicone
implants at this point because they give a much more natural soft feel.
Many women who are very thin and go with larger implants can
have rippling or a firm feel and look to their implants. Many of my patients have been switched from
saline to silicone to have a more natural appearance or decrease their
The surgery is very straightforward in comparison to the
original breast augmentation. The muscle
has already been stretched so patients do not feel the same pressure after
their surgery. Patients are typically surprised how easy the recovery is for an
Changing implants through the armpit is a very straightforward procedure. Using the Keller funnel the silicone implant
can easily be placed into the breast pocket from the axilla.