Breast Implant Revision

Breast implant revision surgery is an option if you are unhappy with your breast implants.

Breast implant revision surgery involves either implant removal and/or replacement with the latest generation silicone breast implants in a newly created surgical breast pocket. The procedure can be carried out to change old implants for larger or smaller implants, or it can be performed to address complications that have developed from primary breast augmentation.

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Breast implant revision aims to produce an aesthetically pleasing look with a more youthful breast appearance. Most types of revision breast implant surgery involve a greater degree of technical complexity than the first breast augmentation procedure. They should only be carried out by suitably skilled plastic surgeons in a dedicated unit treating high volumes of breast implant revision cases.

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We offer the full range of breast implant revision procedures, including breast implant removal, breast implant replacement, breast implant removal combined with a breast lift and fat transfer breast augmentation. Breast implant surgery is the most popular cosmetic surgery procedure performed in the UK. The first majority of women who have breast implants are pleased with the results of their procedure, although a small number of patients may not achieve the results they are looking for and may require breast implant revision.

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Many people enjoy many years of having breast implants with no problems, although, after a certain point, breast implant revision may be required. Other women may develop complications shortly after their procedure has taken place, or they may be dissatisfied with the results and require corrective surgery. Most reputable breast implant manufacturers offer a lifetime warranty, although it is highly likely that implants will eventually develop problems, especially after ten years. Breast implant revision surgery is required for women who have breast implants between 10 and 20 years old. In many cases, the need for breast implant revision surgery could have been minimised by careful preoperative planning and choosing an expert breast specialist to perform your primary breast augmentation.

Breast implant revision surgery is a bespoke surgical procedure designed to address the unique desires and requirements of each patient. This form of surgery caters to a range of needs, from rectifying issues stemming from previous breast surgeries to meeting aesthetic goals such as achieving a more voluminous or lifted bust, enhancing cleavage, or altering the size or type of breast implants. Additionally, some individuals seek this surgery to improve the appearance of scars from their initial breast surgery, aiming for a more refined look at the site of the original incision.

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The necessity for revision surgery often arises due to complications encountered with the initial breast augmentation. In scenarios where a patient faces capsular contracture—a condition where the scar tissue around the implant tightens—surgical intervention might involve removing the scar tissue and possibly replacing the implant to ensure comfort and maintain the desired aesthetic. Similarly, should a breast implant rupture, prompt replacement is essential to preserve the breast’s appearance and health.

Contrary to widespread belief, breast implants do not have a predetermined lifespan, necessitating routine replacement every decade or so. In fact, manufacturers of these medical devices typically offer a lifetime warranty, underscoring their durability and long-term reliability. The majority of individuals who undergo breast augmentation remain satisfied with their results indefinitely, with no need for further revision, assuming no complications arise.

Nevertheless, personal preferences evolve, and some may opt for an update, such as switching from saline to cohesive gel implants, driven by a desire for a different feel or look. This choice underscores the highly individual nature of cosmetic surgery, where personal preference and the pursuit of self-defined beauty standards guide decisions.

1. Changes in the size of breast implant necessitating breast implant replacement

In some cases, many women wish they had chosen larger implants for their first breast implant surgery. Our surgeons commonly hear this from women who have already had a breast augmentation and now prefer to go bigger. Less commonly, women may be surprised at how large their breasts look and wish to have smaller implants. Although breast implant replacement can help change breast implant size or shape, it is not as technically straightforward as primary breast surgery. If you want bigger breast implants, we recommend reflecting on the aspects of your appearance that you would like to alter instead of choosing larger-sized implants. Many women often like to have more cleavage, and choosing implants with a higher projection, also known as high-profile implants, may help to give the impression of enhanced cleavage and upper pole fullness without altering the dimensions of the implant. Some women often prefer to have increased lateral fullness of their breasts, and changing to implants with a broader base may help to give women more lateral boobs.

RELATED: Does breast augmentation enhance cleavage?

What constitutes the ideal aesthetic appearance of the breasts often evolves over time, and having bigger breasts isn’t always the aesthetic ideal. For women who would like to have significantly smaller-sized implants, a breast lift or mastopexy may also need to be performed in the same procedure to address any sagging skin that has developed as a result of stretching out of the skin envelope by having large implants. If you have only had breast implants for less than a few years, then the skin’s elasticity may allow the breasts to undergo a degree of shrinkage around the new smaller-sized implants. The extent of breast skin retraction around the smaller-sized implants is determined by overall skin quality. People who have undergone significant fluctuations in weight or have carried out breastfeeding may be more likely to have poorer skin quality and therefore require a breast lift in the same procedure to tighten the skin.

2. Capsular contracture

Capsular contracture is the most common complication after breast augmentation surgery with implants. The condition can develop as soon as three months after the procedure or as late as 20 years later. Based on current medical opinion, it is impossible to predict who will develop capsular contracture and at what point. Women who develop capsular contracture often notice their breasts feel hard, become deformed in appearance or may cause significant discomfort.

More severe grades of contracture often require revision breast surgery. Surgery for capsular contracture most commonly requires the removal of the existing implant and surrounding affected capsule, also known as an en bloc capsulectomy and replacement with a new implant. In certain cases, your surgeon may create a new pocket for the breast implants and leave the existing capsule behind. The new implant is placed in a brand-new pocket, resulting in a speedy recovery. For women who have previously had a subglandular (over-the-muscle) breast augmentation, the risk of developing capsular contracture can be minimised by creating a new pocket beneath the pectoralis muscle (dual plane).

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Some women may have had several breast implant revision procedures to treat capsular contracture. The thickness of the soft tissues begins to diminish with repeated surgical procedures and may increase the risk of the implant or its edges being visible. The risk of implant rippling is also higher. The best option is to carry out fat transfer to the breast while performing breast implant revision in the same procedure. This is also known as hybrid breast augmentation.

Despite successful treatment of capsular contracture, the condition can still recur despite following all the best guidance for prevention. Patients who develop severe grades of capsular contracture or have had multiple breast revision surgeries may be better suited to having polyurethane breast implants, as these have been shown to reduce the risk of repeated capsular contraction. Patients who smoke should be given help to stop smoking as the prevalence of capsular contracture is doubled in smokers versus non-smokers.

3. Breast implant rupture

Revision breast implant surgery will be required if the outer shell of a breast implant loses its integrity, which may lead to deflation for saline implants or deformation of silicone implants. The rupture of saline implants is easy to recognise, with an obvious reduction in breast size similar to a deflated balloon. Silicone implant rupture can be more difficult to diagnose. Patients may experience pain or discomfort in the affected breast or notice a deformed appearance due to a ruptured implant.

MRI is the most appropriate diagnostic imaging investigation to diagnose silicone implant rupture. An MRI scan can assess the integrity of the outer implant shell and detect silicone that may have migrated into the surrounding tissues. An ultrasound scan is a suitable alternative if patients are not keen to have an MRI scan. However, diagnosing breast implant rupture on ultrasound is highly operator-dependent and requires a skilled practitioner. Modern breast implants containing silicone have a very low risk of rupture of less than one per cent. Medical grade silicone in the latest generation implants has a highly cohesive nature. This means that if a rupture occurs, the silicone does not leak out like a runny liquid and remains within the implant shell or the surrounding capsule. The breast capsule surrounding an implant is composed of scar tissue and is the body’s normal reaction to a foreign body, including breast implants.

Breast implants have a finite lifespan, which means that as breast implants age, they are more likely to develop breaches in the integrity of the outer shell, including minor cracks or larger tears. These will require revision breast implant surgery at the earliest opportunity to minimise the risk of complications occurring.

4. Breast implant malposition

The position of breast implants may change if the breast pocket is excessively large in a certain direction. Breast implants may migrate downwards or upwards. They can also migrate outwards towards the armpit or inwards, known as symmastia. The best way to prevent or minimise these issues is to ensure meticulous surgical technique is used throughout the procedure. Our expert breast specialists are experienced in creating breast pockets with precise dimensions to accommodate the size of your chosen implant. This helps to prevent implant displacement and possible malposition. Patients who choose excessively large implants have a higher risk of developing implant displacement. Implants that are 500cc or larger are more likely to migrate downwards or outwards due to their heavier nature. Implants that are positioned over the muscle, also known as the subglandular approach, have a greater risk of downward displacement. Implants placed beneath the muscle are more likely to displace outwards.

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5. Excessively large breast gap or wide cleavage

Breast implants can displace outwards towards the armpit, and this can result in a reduction in the appearance of breast cleavage. When people lie flat, it is normal for the breasts to move laterally. When people are standing or sitting, breast implants should not displace laterally. An excessively large breast implant pocket from overzealous dissection or natural expansion with time can result in the implants migrating laterally to the sides and is especially noticeable when lying down. Some women may have chest wall deformities, such as pectus carinatum. This condition creates an excessive curvature of the chest wall and increases the likelihood of lateral displacement of breast implants despite an appropriately sized breast pocket.

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6. Symmastia or ‘uniboob’

When breast implants move medially or towards the sternum, this is known as symmastia or a ‘uniboob’. Symmastia has a greater risk of occurring with subglandular placement of implants. It can, however, also occur from the excessive surgical release of the pectoralis muscle fibres in its inner aspect as part of the dual plane approach combined with the insertion of an excessively wide breast implant.

Symmastia most commonly relates to an excessively large breast pocket in women who may have a pre-existing deformity of the chest wall, such as pectus excavatum. This increases the likelihood of breast implants migrating in an inwards direction. Surgical treatment for symmastia is complex and difficult. Revision breast surgery involves adjusting the size of the pockets using suture reconstruction and changing to a smaller-sized implant with a slimmer base.

7. Double bubble deformity

A double bubble deformity is known as a static deformity, as it is visible when the breasts are in a resting state. In this condition, the breast implant is located below the normal lower breast fold, leading to the formation of an extra crease below the level of the breast implant. This can look unsightly. Causes of a double bubble deformity include excessively large implants, short nipple to IMF distance, capsular contracture, tuberous breast deformity or a well-defined inframammary fold. Surgery to correct a double bubble deformity is considered technically challenging. The exact surgical technique used will depend on the extent of surgical correction required.

8. Animation deformity

Animation deformity results in implants migrating upwards and outwards with muscle contraction in patients who have breast implants placed beneath the muscle. The condition can occur due to both excessive and inadequate release of pectoralis muscle fibres along the breast bone or may occur over time as the soft tissue begins to lose its thickness. The condition is more common in women with well-developed chest muscles who carry out upper body resistance exercises. The condition can be corrected by repositioning the breast implant into a subglandular position above the muscle. The implant is replaced with a highly cohesive breast implant and may be supported in its position with the use of acellular dermal matrix (ADM).

9. Breast implant rippling

Patients who have insufficient soft tissue coverage over their implants are at risk of developing implant rippling. Women most commonly notice a wavy appearance, especially when they bend over. Implant rippling occurs more commonly with subglandular implant placement than with implants placed beneath the muscle. Textured implants with a lower cohesiveness or softer feel are more likely to develop rippling compared with smooth implants. The latest generation of highly cohesive anatomical implants has a low risk of implant rippling. When breast implants are placed on top of the muscle, breast implant rippling is most commonly seen within the inner aspect of the breasts and may look cosmetically unacceptable. Many women describe their breasts as looking fake when rippling affects their cleavage area. The best solution is to create a new breast pocket beneath the muscle and change to highly cohesive anatomical textured implants. Implant rippling may occasionally be seen with submuscular placement of implants in the outer aspect of the breast, as the pectoralis muscle does not cover this area. The pectoralis muscle covers the inner aspect of the breasts, so any implant rippling is less visible with the submuscular approach. The best treatment for lateral implant rippling is to replace the implants with a highly cohesive, form stable anatomical textured implant.

Breast implant revision surgery is a complex and highly personalised procedure that mirrors the initial breast augmentation in several ways, yet is intricately designed to meet specific post-operative challenges or aesthetic aspirations. The surgical strategy employed by your surgeon will largely depend on the unique circumstances prompting the revision, with meticulous planning to ensure the best possible outcome.

When undergoing a breast implant revision, the experience begins in a similar manner to your initial surgery, with surgeons typically opting to use the same incision sites. This choice helps to minimise additional scarring by utilizing the natural contours and healing patterns established during your first procedure. The essence of the revision, however, may differ based on the specific concerns or desired improvements.

Addressing capsular contracture forms a significant portion of revision surgeries. This condition involves the formation of tight scar tissue around the implant, leading to discomfort and an unnatural feel and appearance of the breasts. To counteract this, the surgeon may remove or release the scar tissue, which not only alleviates discomfort but also restores the natural movement and feel of the breasts. Following this, the insertion of a new implant is carried out, ensuring that the aesthetics and comfort are significantly improved.

In cases where an implant has ruptured, the procedure for revision is somewhat streamlined, thanks to the policies of implant manufacturers like Mentor and Motiva, who often provide a replacement implant at no additional charge. The surgeon will remove the damaged implant and replace it with a new one, a straightforward process that underscores the commitment to patient safety and satisfaction.

Breast Lift

For patients seeking to incorporate a breast lift into their revision surgery, the procedure becomes more intricate. The surgeon makes a new incision that encircles the areola and extends in a straight line down to the breast crease. This approach allows for the removal of excess tissue, addressing sagging effectively. The repositioning of the nipple to a higher or more forward-facing location on the breast further enhances the lifted and youthful appearance.

Fat Transfer to Breasts

Adding a fat transfer to the revision surgery introduces another dimension to the procedure. This technique is especially appealing for those looking to enhance the shape or volume of their breasts while simultaneously removing unwanted fat from other body areas. The process involves liposuction from areas with excess fat, such as the thighs or abdomen. The harvested fat is then purified and reinjected into the breasts, allowing for subtle enhancements in cleavage or breast contour, marrying the concepts of reduction and augmentation seamlessly.

Adjusting the size, style, or position of implants requires a keen assessment of the existing breast tissue and space. The surgeon may need to modify the breast pocket to accommodate the new implant’s volume or shape, ensuring a harmonious and aesthetically pleasing result.

The duration of the operation can vary widely, generally spanning from one to three hours, contingent upon the surgery’s complexity. Patients undergoing general anaesthesia are cared for by a dedicated anaesthetist before, during, and after the procedure to ensure the utmost safety and comfort. Similar to the initial augmentation, arrangements for post-operative care are crucial, necessitating someone to accompany the patient home and provide support during the first 24 hours of recovery.

The path to recovery after breast implant revision surgery is as unique as the procedure itself, varying widely among patients due to the diverse nature of the revisions undertaken. Despite this variability, a common sentiment shared by many is that the recovery from revision surgery often feels more manageable than the initial breast augmentation experience. This perception can be attributed to the body’s prior adjustment to the implants, where the tissues have already stretched and conformed to accommodate the initial implants, leaving primarily the healing of the incisions as the main concern during the recovery phase.

After surgery, it is normal to experience some degree of discomfort. Minor pain and fatigue are common in the first 72 hours post-operation. These symptoms are a natural part of the healing process as the body begins to recover from the surgical intervention. To support a smooth recovery, patients are advised to avoid strenuous activities, particularly those that involve heavy lifting or raising the arms above the shoulders. Such precautions are crucial to prevent undue stress on the healing incisions and the newly adjusted breast tissues.

For individuals with caregiving responsibilities, especially those caring for small children, planning is essential. It’s important to arrange for additional help in the days following the surgery to ensure that recovery can proceed without unnecessary strain or movement that could compromise the healing process.

Adherence to postoperative care instructions provided by your surgeon is paramount for a successful recovery. Surgeons tailor their recommendations to each patient’s specific situation, considering the details of the revision surgery and the individual’s overall health. By closely following these guidelines, patients can significantly reduce the risk of complications, ensure a more comfortable recovery, and ultimately enhance the outcome of the surgery.

The emphasis on following the surgeon’s advice cannot be overstated. This comprehensive approach encompasses a range of post-operative care measures, from managing pain and preventing infection to ensuring proper wound care and gradually resuming physical activities. It is designed to facilitate a smooth and effective healing process, enabling patients to achieve the best possible results and satisfaction with their revised breast appearance.

There are several reasons why you would want to remove your breast implants, including for women who developed symptoms of breast implant illness (BII).

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Many people have decided they no longer wish to have implants and may have breast implant removal alone. They can also have implant removal combined with breast fat transfer for natural-looking results without the risks of implants. Women who have had large implants for a long time may need breast implant removal combined with a breast lift to eliminate loose skin.

Some women may prefer to have breast implant replacement surgery to change their implants from a textured surface to a smooth surface as they may be concerned about the risks of BIA-ALCL. Others would like to have the latest generation of breast implants after having had ageing implants for over ten years and may not have experienced any breast implant-related problems.

How to finance the cost of your breast implant revision

Centre for Surgery is an approved partner of Chrysalis Finance, the leading medical finance provider in the UK. We offer various flexible finance options, including 0% finance for eligible applicants. Please call us today to learn more about the finance options available at 020 7993 4849.

Is breast implant revision worth it?

Most patients who have breast implant revision at Centre for Surgery tell us how their self-confidence has developed significantly with an associated improvement in emotional well-being. Most patients wish they had chosen us many years earlier for breast implant revision. Patients can look forward to a refreshed and youthful look, which helps them to feel better about themselves and boost their overall physical and mental health.

The cost of breast implant revision surgery will be determined by your breast implant problem and the extent of surgical correction required. Here at Centre for Surgery, you will receive a package price for your procedure that includes your surgeon, anaesthetist, and facility fees. The price of breast implant revision also includes post-operative after-care, follow-up appointments and any ongoing post-operative support as required. Once you have had your in-person consultation, you will receive a detailed quotation from your dedicated patient coordinator. We would recommend reflecting on all aspects of the consultation for two weeks as part of a recommended two-week cooling-off period.

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Centre for Surgery is considered the leading cosmetic surgery clinic in London and is home to some of the best consultant breast specialists in the UK. Our surgeons perform hundreds of breast procedures yearly at our state-of-the-art Baker Street clinic in Marylebone. We regularly see patients who have had primary breast augmentation elsewhere and have developed complications from their surgery. We are pleased to offer in-house high-resolution ultrasound scanning for patients who cannot have an MRI scan to assess the condition of the implants in selected cases. Our surgeons have refined their surgical techniques over time and are committed to learning the latest techniques in breast implant revision by attending national and international conferences. Our highly trained staff will ensure that you are fully informed whilst providing world-class cosmetic surgery in a personal and caring environment. If you would like to schedule an appointment with an expert breast specialist, please call us at 020 7993 4849 or fill out the contact form below to arrange an in-person consultation.