Posted by Laurence Weider on October 22, 2024

One of the most requested procedures at Weider Plastic Surgery is some type of revision to prior breast augmentation. Most breast implant revisions can be categorized into either removal and replacement of implants, which is often performed at the same time as additional modifications are made, or an implant removal procedure. We will focus primarily on the revisions where new implants are placed in this blog.

Breast implant revision surgery is typically sought for various reasons, ranging from aesthetic changes to medical concerns. Here are the most common reasons:

1. Desire to Change Implant Size or Shape

Many women choose breast implant revision surgery to either increase or decrease the size of their implants or to change the implant shape.  Typically, at the same time, additional adjustments are performed such as a pocket adjustment or a breast lift.

2. Capsular Contracture

This occurs when the capsule (the scar tissue that naturally forms around the implants) becomes unusually tight, hard, or painful, leading to discomfort or a distorted appearance. Capsular contracture can occur fairly soon after breast augmentation surgery or many years later. A capsular contracture that occurs years after the breast implants were placed can be a sign of a leaking gel implant.  At Weider Plastic Surgery we take many crucial steps during the initial breast implant procedure to decrease the possibility that a capsular contracture will occur.  An implant revision for capsular contracture typically includes the removal of the involved capsule and the replacement of the implant with a new implant.

3. Implant Rupture or Leakage

Ruptures can occur with both silicone and saline implants. When saline implants leak, the patient is usually aware because the involved breast gets smaller. Silicone leakage is usually not as easy to detect, and an ultrasound or MRI may be needed for detection. In either case, the ruptured implant should be removed and replaced with a new implant.  If there is any leakage of silicone, it should be cleaned out.

4. Implant Malposition or Asymmetry

Implants can shift from their original position over time, causing asymmetry or an unnatural appearance. This can include implants that sit too high, too low, or drift outward. Implants that drift too low or outward (towards the arm) are addressed with a technique called a capsulorrhaphy which means repair of the capsule (implant pocket). This is usually done with internal sutures but sometimes mesh is used like an “internal bra.”  If the implants are too high, then the pocket is typically lowered.

 5. Changes in Breast Tissue

Pregnancy, breastfeeding, weight fluctuations, and aging can affect natural breast tissue, potentially leading to sagging (ptosis) or other changes that may prompt revision. This is a common reason for women to seek out revisional surgery. The revision often involves the replacement of the implants with new ones.  In addition, some type of breast lift is often performed in order to remove loose skin, elevate the nipples and areolae (if indicated), and reshape the breasts. The new implants may be smaller or larger than the original implants depending on the patient’s preference.

6. Double Bubble Deformity

This occurs when the implant drops below the natural breast crease leading to the appearance of two breast creases.  This is usually repaired by restoring the position of the breast crease with internal sutures.

7. Rippling or Wrinkling

This can happen when the implant’s edges or folds become visible through the skin, especially in patients with thin skin or minimal breast tissue. Possible options for repair include the replacement of the current implants with more cohesive gel (gummy bear) implants or with a breast lift or pocket adjustment (or some combination of these).

8. BIA-ALCL (Breast Implant-Associated Anaplastic Large Cell Lymphoma)

Although rare, this form of lymphoma has been associated with certain types of textured implants, leading some women to seek revision or removal of their implants in order to decrease the chance of ALCL from occurring in the future.

9. Desire to Remove Implants

Some women choose to remove their implants altogether, either due to personal preference or concern over health issues related to breast implants, such as Breast Implant Illness (BII), which involves a wide range of systemic symptoms that some women report after implantation. Breast Implant Illness is covered more thoroughly in another blog. Implant removal is often combined with a breast lift.

We offer a few different types of breast lifts and tailor the lift to each patient’s anatomy and personal preference.

Seeking breast implant revision is a highly personal decision, often made to restore confidence, correct complications, or improve overall comfort and appearance.

During your consultation at Weider Plastic Surgery, Dr. Weider will discuss your goals and perform a thorough exam. Your options and their associated benefits will be reviewed with you in detail, and all of your questions will be answered.  Give us a call at (972) 566-8444 to schedule your personal consultation.

Dr weider

Dr. Weider, a native of Southern California, is a Board-Certified Plastic Surgeon who has maintained a private practice in Dallas, TX since 1999. After attending Stanford University, he obtained his medical degree (M.D.) from Baylor College of Medicine in Houston. He then completed a one year surgical internship in Los Angeles at Harbor-UCLA Medical Center, followed by a four year general surgery residency in Dallas at Methodist Medical Center, and a two year plastic surgery fellowship in Cleveland at Case Western Reserve University.

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