Should implants be removed through the same incision, given the visible dents of prior incisions under the nipple? (Photo)

I am 63 years old and have had three augmentations. I want to have implants removed, not replaced. The incisions are indented so that the nipple falls down a bit over the incision. What is the risk of having the nipple completely cave in over the incision if that same site is used to remove the implants? Should I consider a different incision under the breast to remove the implants?

Doctor Answers 12

Should implants be removed through the same incision as they were placed through?

Thank you for your question and photographs.  If you are not looking to have any ancillary procedures placed I would advise using your preexisting scar to revise its indented appearance after implant removal.  Hope this helps.


Atlanta Plastic Surgeon
5.0 out of 5 stars 43 reviews

Should implants be removed through the same incision, given the visible dents of prior incisions under the nipple?

Thank you for your pictures and questions. I think that if you already have a scar in place that you do not like, this is the perfect opportunity to remove the implants through that scar and have the scar revised. If you are having the implants removed and not replaced, you also need to discuss what to do to the breast to prevent a deflated appearance. Make sure you see a board certified plastic surgeon in your area to discuss details.

Good luck!

Should implants be removed through the same incision, given the visible dents of prior incisions under the nipple?

It's a good question. Your implants could be removed through the previous incisions. This could give your surgeon an opportunity to attempt to improve on the "dent" in the incision. Multiple layers of sutures could be removed to bring tissue under the incision to prevent the area of depression.

However, if you prefer to stay away from these incisions, for fear of making them worse, implants can always be removed through an incision in the crease below the breast.

Good luck with your upcoming surgery. Make sure to see a board-certified plastic surgeon.

Breast surgery and scars

 Thank you for your question. It doesn't make much sense to use the new incision when you already have a pre-existing scar.  There are things to be done at the time of surgery to improve your periods of the scar and prevent the scar contracture. 

Incision Choice

In most cases I prefer to use the preexisting scar to avoid having a second mark on the skin. But when I see patients with your issue, I always recommend the incision below the breast for implant removal and at the same time do a superficial scar revision around the areola to try and flatten that scar. It comes from deep adhesions and to make another deep incision runs the risk of making the indent worse. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 reviews

Should implants be removed through the same incision, given the visible dents of prior incisions under the nipple?

Thank you for your question.  Some may prefer to use an inframammary incision to ease the removal; however, when one already has an established scar it may make sense to use a preexisting scar and at the same time potentially revise that same scar.  Discuss your thoughts with your surgeon, good luck.

David J. Wages, MD
Peabody Plastic Surgeon
5.0 out of 5 stars 19 reviews

Should implants be removed through the same incision, given the visible dents of prior incisions under the nipple?

The incision I use most frequently for breast implant removal is the infra mammary fold incision. I share your your concerns about “caving in” deformities; they may be more common if the infra areolar incision is used for breast implant removal.

 You may find the attached link, dedicated to breast implant removal surgery concerns, helpful to you as you learn more. Best wishes.

Incision and Removal

Removing the implants through the original incision site can revise the scar, as well as eliminate the need to make an additional scar.  

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 55 reviews

Best incision for removal of breast implants

It is usually recommended that existing scars be used for secondary procedures. This would prevent the need to have extra scars on the breasts. Using the existing scars would also  provide an opportunity to improve problems relating to the scars. The expected outcome of a scar revision can be generally predicted based on the appearance, feel, and history of the scars. This can be provided by your surgeon during a consultation. 

Wayne I. Yamahata, MD
Sacramento Plastic Surgeon
4.9 out of 5 stars 41 reviews

Removing breast implants and incisional scar denting

Decades of experience have shown that putting implants in through a periareolar incision is a poor choice for a number of reasons including indenting scars. I would definitely not remove them through another periareolar incision. Breast implants are best removed (and placed) through an inframammary crease incision. For saline-filled implants, a simple removal can be done with local anesthesia alone. 
After removing the implants through an inframammary crease incision, I would evaluate the result and the need for any corrective or adjustment type procedures including a scar revision of the indented periareolar incision scars. Scar revisions can also be done with local anesthesia alone. 

Scott L. Replogle, MD
Boulder Plastic Surgeon
4.0 out of 5 stars 1 review

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.