Dr. Nathaniel Stroumza-Escoffier, plastic surgeon in Paris. Last updated: July 2026.
A breast implant isn't permanent: it may need replacing after a few years due to a change in volume, wear and tear on the prosthesis, or simply to update the desired aesthetic. Many patients then dread a new scar under the breast . However, when implants have been placed via the axillary approach—that is, through the armpit—it's often possible to reuse this same scar. This is a little-known option, one that few surgeons discuss.
The essential
When breast augmentation has been performed via the axillary approach, implant replacement can, in many cases, be done through the same incision—without a new scar on the breast. Feasibility depends on the individual situation and is confirmed during a consultation.
Why do we think that a change requires a new scar?
Because the most common approach for implant placement is the inframammary incision, which leaves a scar in the crease under the breast. When considering a replacement, people naturally assume they'll go through the same procedure again. However, the initial access route determines the possibilities: if the implants were inserted through the armpit, they can often be replaced through the armpit as well.
The axillary route, in brief
The axillary approach involves inserting the implant through a short incision hidden in a natural crease of the armpit. Its advantage: no scar on the breast itself . The scar, already discreet to begin with, remains hidden in a naturally creased area.
Reusing the axillary scar: in what cases?
When implant replacement is considered after axillary placement, it is often possible to use the same approach to remove the old prosthesis and insert the new one. This requires a suitable situation: a well-preserved implant pocket, a procedure plan consistent with the surgical approach, and no additional procedures requiring a different access point. The decision is made after examination and, if necessary, imaging.
What benefits?
- No new breast scars : the breast is not marked by a new incision;
- Respect for the initial aesthetic design : we retain the logic of the original surgery;
- A more conservative surgery, continuing from the first intervention.
In what cases is this impossible?
This approach is not universal. Certain situations require a different approach—most often submammary: significant capsular contracture to treat, modification of the implant plane, correction of asymmetry or position, or combination with a breast lift when the skin has become lax. Here again, the analysis of each individual case determines the best course of action: the objective remains the best possible result, not the procedure at any cost.
How is the first route decided?
During the consultation, the examination will determine the initial surgical approach, the condition of the implant pocket and implants, skin quality, and your expectations. This assessment will determine whether the axillary scar can be reused or if another access route is preferable. Minimally invasive techniques, such as MIA implants , are part of this same pursuit of discreet scarring.
In practice
Are you considering implant replacement and want to avoid a new scar on your breast? The feasibility of the axillary approach is assessed on a case-by-case basis. Schedule an appointment for a personalized evaluation.
This article is for informational purposes only and does not replace a medical consultation.
