Signs You May Need Breast Revision Surgery

Breast augmentation provides long-lasting results, but breast implants are not lifetime devices. Understanding the signs that may indicate a need for revision surgery helps you maintain optimal results and address concerns promptly.

Common Reasons for Breast Revision

Capsular Contracture

Capsular contracture is the most common complication requiring revision. It occurs when the natural scar tissue capsule around an implant tightens and hardens.

Capsular Contracture Grading Scale:

The Baker grading system classifies capsular contracture severity:

• Grade I: Breast feels soft and looks natural (normal)
• Grade II: Slightly firm but looks normal
• Grade III: Firm and appears abnormal
• Grade IV: Hard, painful, and visibly distorted

Grades III and IV typically require surgical intervention. Treatment involves removing the hardened capsule (capsulectomy) and may include implant replacement.

Implant Rupture or Deflation

All implants can eventually rupture, though modern implants are highly durable.

Saline Implant Rupture: - Immediately noticeable as the breast deflates - Saltwater is safely absorbed by the body - Requires replacement but not urgent

Silicone Implant Rupture: - May be "silent" with no immediate symptoms - Gel typically stays within the capsule - MRI recommended for detection - Surgical removal and replacement recommended

Position Changes

Over time, implants may shift from their original position:

Bottoming Out The implant descends too low, causing the nipple to appear too high on the breast mound.

Lateral Displacement Implants shift toward the armpits, especially when lying down, creating excessive side cleavage.

Symmastia Implants shift toward the center, creating a "uniboob" appearance where implants touch in the middle.

High Riding Implants Implants fail to descend properly post-surgery, sitting too high on the chest.

Aesthetic Concerns

You may want revision for reasons unrelated to complications:

• Desire for different size (larger or smaller)
• Preference for different implant type or profile
• Want to update to newer implant technology
• Asymmetry that has developed over time
• Visible rippling or wrinkling
• Changes due to weight fluctuation, pregnancy, or aging

When to Seek Evaluation

Schedule a consultation if you notice:

• Breast hardness or firmness
• Changes in breast shape or position
• New asymmetry between breasts
• Pain or discomfort
• Visible implant edges or rippling
• Unexplained changes in appearance
• It's been 10-15 years since your implants were placed

What Revision Surgery Involves

Revision surgery is often more complex than primary augmentation. Your surgeon may:

Address the Capsule - Capsulotomy (releasing the capsule) - Capsulectomy (removing the capsule) - En bloc removal in some cases

Modify the Pocket - Adjust pocket size and position - Change from subglandular to submuscular (or vice versa) - Create new pocket if needed

Replace or Change Implants - Same or different size - Different type (saline to silicone or vice versa) - Different profile (moderate, moderate plus, high)

Add Support - Acellular dermal matrix (internal bra) - Fat grafting for additional coverage

Recovery Expectations

Revision recovery is similar to primary augmentation:

• First week: Rest, limited activity, moderate discomfort
• Weeks 2-4: Return to light activities and work
• Weeks 4-6: Most activities resumed
• Months 3-6: Final results visible

Some revision procedures may have slightly longer recovery depending on complexity.

Choosing a Revision Surgeon

Revision surgery requires specialized expertise. Look for:

• Board-certified plastic surgeon
• Extensive experience with revision cases
• Understanding of your specific concerns
• Ability to show before-and-after photos of similar cases
• Clear communication about realistic expectations

The Bottom Line

If you're experiencing any signs of implant problems or simply want to update your results, consultation with a qualified plastic surgeon can help you understand your options. Modern revision techniques can address most concerns and restore your satisfaction with your breast surgery results.