What is the Best Incision Area for Explanting?

I have implants over the muscle and am now explanting. The implants were put in under the aerola and will be removed the same way. Is there a higher chance of the nipple caving in or creasing removing the implant this way?

Doctor Answers 8


the best way to remove the implants is the same way they were placed. There is no reason for a new incision unless the job cannot be properly done through the existing scar.

New York Plastic Surgeon
4.9 out of 5 stars 14 reviews

Incision choices for removal of breast implant

Generally I would recommend using the same incision to remove the breast implant as it was placed unless there are other circumstances such as breast lift. The chance of nipple caving in or creasing is based on how long and how big the implant in relation to your breast tissue. How much has the skin been stretched and how little your original breast tissue will determine whether you ended it up with caving in or creasing. 

Best Wishes,

Stewart Wang, MD FACS, Wang Plastic Surgery

Stewart Wang, MD, FACS
Los Angeles Plastic Surgeon
4.6 out of 5 stars 28 reviews

Best Approach to Remove Breast Implants?

Thank you for the question. Generally speaking, I remove breast implants through incisions that were previously used.  However, your concern about “caving in” is understandable;  however, I think that this  contour deformity can occur regardless of the incision used to explant. Because of the inflammation/scarring that will occur with an incision around the areola, it is possible that there is a higher chance of this contour deformity occurring when breast implants are removed through an incision under the areola.  Ultimately this potential increase risk needs to be weighed against the desire to avoid additional scars on the breasts.  I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,487 reviews

What is the Best Incision Area for Explanting?

Plastic surgeons generally use the same incision for explantation of breast implants. It may be necessary to switch to a breast crease incision (inframammary fold) if extensive capsule removal or other procedures are necessary.

You could have poor cosmetic appearance of your nipples from any approach. This could happen due to deflation of tissues or the healing process. Depression of the scar around the areola would be specific to the areolar incision approach. Talk to your plastic surgeon about these concerns and he or she will help you with your decision.

Best regards,

Michael Vennemeyer, MD

Michael Vennemeyer, MD
Southlake Plastic Surgeon
5.0 out of 5 stars 48 reviews

Old incision is the best incision

There is no relationship between which incision is used for explantation and nipple appearance after surgery. Previous incisions are usually the favorite.

Armin Moshyedi, MD
Bethesda Plastic Surgeon
4.6 out of 5 stars 21 reviews

Incisions for explanting breast implants

I would disagree with some of the other responses. In general, it's never a good idea to go back through a peri-areolar incision to get at an implant. You are correct that there is a risk of distortion in the breast tissue under the nipple-areola among other drawbacks. This is a good reason not to use it in the first place as removing the implant or changing it in later years is fairly common and the best way to do this is with an inframammary crease incision. Experience seems to indicate that the inframammary incision is the best for both short term results and long term issues. This only has to be 2 cm for saline implants and 3.5 cm or so for silicone gel-filled implants. Capsulectomy is generally not necessary with explantation of an implant but if it is required, an inframammary crease incision is the way to approach it. 

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

Best incision for breast implant removal

Your surgeon will likely recommend the incision that he/she thinks will facilitate the operation.  If your nipples are really small and a capsulectomy (removal of the scar capsule) is recommend, he/she will likely need a longer incision, such as one under the breast.  It is nice to be able to use the prior incision and scar for surgery, but sometimes it just isn't long enough to accomplish what needs to be done. 


If a breast lift is done after removal (one of my fave operations), the lift incision is used to remove the implant and capsule.

Lisa Lynn Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 72 reviews

Incision and implant removal

I usually use the incision that was used for the prior surgery as long as it is on the breast. A transax or umbilical incision will not provide adequate access. As for indentations, it is difficult to predict when this will occur.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 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.