Breast implants can provide long-lasting results, but they are not considered lifetime devices. Your breasts, surrounding tissues and personal preferences may change over time, while the implants themselves can occasionally develop complications.
Breast revision surgery is a secondary procedure performed after a previous breast augmentation. It may involve replacing or removing an implant, adjusting its position, treating scar tissue or combining implant surgery with a breast uplift.
Needing revision surgery does not necessarily mean that anything went wrong during the original operation. In many cases, it is required because the body and breasts naturally change over time.
What Does Breast Revision Surgery Involve?
Breast revision surgery is tailored to the individual patient. Depending on the concern, it may involve:
- Removing and replacing the implants
- Changing the implant size or profile
- Repositioning an implant
- Repairing or tightening the implant pocket
- Removing or releasing scar tissue
- Combining implant surgery with a breast uplift
- Removing the implants without replacing them
The most appropriate approach will depend on your existing implants, breast tissue, skin quality and desired outcome.
Capsular Contracture
The body naturally forms a layer of scar tissue, known as a capsule, around every breast implant. This capsule usually remains soft and causes no problems.
Capsular contracture occurs when the scar tissue tightens around the implant. The breast may become unusually firm, painful, distorted or positioned higher than expected.
More significant cases may require the capsule to be released or removed, with or without replacement of the implant. However, capsular contracture can return following revision surgery.
Breast Implant Rupture
Although breast implants are designed to be durable, their outer shell can weaken or become damaged over time.
A silicone implant rupture does not always cause obvious symptoms. This is sometimes described as a silent rupture. When changes do occur, they may include:
- A change in breast size or shape
- Increased firmness
- Swelling or discomfort
- A lump within the breast
- A change in how the implant feels
Imaging may be recommended if a rupture is suspected. A confirmed rupture will usually require removal of the affected implant, followed by a discussion about replacement.
Implant Movement or Malposition
Breast implants sit within surgically created pockets. If the surrounding tissues stretch or the pocket changes, an implant may move away from its intended position.
This can include:
- Bottoming out, where the implant moves too low
- Lateral displacement, where it moves towards the armpit
- Medial displacement, where the implants move too close together
- A high-riding implant
- Rotation of a shaped implant
Revision surgery may involve repositioning the implant, repairing the pocket or selecting an implant with dimensions better suited to the patient’s anatomy.
Changes Following Pregnancy, Ageing or Weight Loss
Pregnancy, breastfeeding, ageing and weight changes can affect breast volume, skin elasticity and nipple position.
The natural breast tissue may begin to droop over the implant, or the breast may appear emptier following weight loss. Replacing the implant alone may not correct these concerns.
In some cases, revision surgery may need to be combined with a breast uplift to remove excess skin and reshape the breast.
Rippling or Visible Implant Edges
Implant rippling occurs when folds within the implant become visible or can be felt through the skin. It is more common in patients with relatively little natural tissue covering the implant.
Rippling may become more noticeable following weight loss or tissue thinning. Treatment options can include changing the implant, adjusting its position or using fat transfer to provide additional coverage. However, it may not always be possible to remove rippling completely.
Changing Your Implant Size
A patient’s preferences can change after their original breast augmentation. Some decide that they would like a fuller result, while others feel their implants are too large, heavy or no longer suited to their lifestyle.
Changing implant size may also require adjustments to the implant pocket. Downsizing can leave stretched skin, while a substantially larger implant may place additional strain on the tissues.
When implant replacement is appropriate, Mat Griffiths uses MENTOR silicone gel breast implants. The implant selected will be based on your current breast measurements, tissue coverage and intended result.
Implant Removal Without Replacement
Some patients decide they no longer want breast implants. Following removal, the breasts may appear smaller, emptier or more drooped, particularly where the skin has stretched.
Implant removal may therefore be performed alone or combined with a breast uplift. Capsule removal is not automatically required in every case and will depend on the condition of the capsule and the reason for surgery.
When Should You Seek Medical Advice?
You should arrange an assessment if you notice:
- New or persistent breast pain
- Sudden swelling
- A new breast or armpit lump
- Significant hardening
- A change in breast shape or implant position
- Redness, heat or other signs of infection
Late-onset swelling around an implant requires investigation. Although uncommon, Breast Implant Associated Anaplastic Large Cell Lymphoma, or BIA-ALCL, can develop in the fluid or capsule around an implant and most commonly presents as delayed breast swelling.
Planning Breast Revision Surgery
Revision breast surgery is often more complex than an initial augmentation because the surgeon must consider the existing scar tissue, implant pocket and changes to the breast tissues.
During your consultation, Mat Griffiths will assess your implants and breast anatomy, discuss the concerns you would like to address and explain what can realistically be achieved through further surgery.
