Revision augmentation mastopexy is further surgery to correct or improve the result of a previous breast lift with implants. Common reasons include recurrent droop, implants that have dropped or moved, capsular contracture, asymmetry, poor scarring or a wish to change size. Most revisions are planned at least six to twelve months after the original operation, once the tissues have settled, and they are usually more complex than the first procedure.
Why revision is sometimes needed
Augmentation mastopexy asks a great deal of the breast tissues, so a proportion of patients will need further surgery at some point. Common reasons include:
- Recurrent ptosis: the breast tissue descends again over time, sometimes leaving the implant sitting high while the breast drops below it.
- Implant malposition: the implant moves too low (bottoming out), too far to the side or too high.
- Capsular contracture: the capsule around the implant tightens, causing firmness, distortion or pain.
- Asymmetry: noticeable differences in size, shape or nipple position.
- Scarring: stretched, thickened or uneven scars.
- Size change: a wish for smaller or larger implants, or for implant removal.
- Implant problems: rupture or other issues requiring replacement.
Life events such as pregnancy or significant weight change can also alter the result and prompt revision.
How long to wait
Swelling and settling continue for many months after augmentation mastopexy, and scars take 12 to 18 months to mature. For most cosmetic concerns, Mr Nassab recommends waiting at least six to twelve months before planning revision, so the true result can be judged and the tissues have recovered their blood supply. Earlier surgery may be needed for problems such as infection, a wound that will not heal, significant bleeding or an implant becoming exposed.
What revision can and cannot improve
Revision can often:
- Re-lift the breast: tightening the skin envelope again and repositioning the nipple where there is enough tissue.
- Reposition or replace implants: including changing size, profile or pocket position.
- Treat capsular contracture: by removing or releasing the capsule and usually replacing the implant.
- Improve symmetry: by adjusting one or both sides.
- Refine scars: through scar revision once they are mature.
There are limits. Repeated surgery can thin the tissues and reduce blood supply, so there may be less scope to reposition the nipple safely. Perfect symmetry is not achievable, sensation that has already changed may not return, and very large implants may not be advisable if the tissues have stretched. Sometimes the safest option is to remove implants and perform a lift alone.
Why revision is more complex
Revision surgery works with scar tissue, altered anatomy and a blood supply that has already been disrupted by previous incisions. The surgeon needs to understand what was done before, including the lift pattern, implant type, pocket and any nipple repositioning. Operating time can be longer, internal support such as additional stitching of the pocket may be needed, and the risks of wound healing problems and nipple changes are generally higher than at the first operation. Recovery can take a little longer too.
The assessment process
At consultation Mr Nassab will take a detailed history of your previous surgery and, where possible, obtain operation notes and implant details from your original provider. He will examine the breasts, assess skin quality, implant position and capsule firmness, and may request an ultrasound or MRI scan if rupture is suspected. He will then explain the options, which might range from an implant exchange with uplift to removal, and what each can realistically achieve. Related procedures include change of implants and implant removal.
Cost of revision
Because every revision is different, it is quoted individually at consultation. For reference, a change of implants with uplift starts from £13,500 and implant removal with uplift from £11,500. The £150 consultation is charged separately.
Recovery after revision
Recovery follows a similar pattern to the original operation, with a supportive bra for around six weeks, a gradual return to activity and scar care once healed. Warning signs are the same: rapid one-sided breast swelling needs urgent contact with the surgical team, fever or spreading redness needs a same-day call, one-sided calf pain needs a same-day GP or NHS 111 assessment, and chest pain or breathlessness warrants a 999 call. See the recovery guide for detail.
Frequently Asked Questions
Can a revision be done if the original surgery was abroad?
Yes, although it helps greatly to have your operation notes and implant details. Mr Nassab will assess you and explain what can be achieved.
Will revision surgery leave new scars?
Surgeons usually work through existing scars where possible, although a different lift pattern may sometimes require additional incisions.
Is it possible to remove the implants and keep a lifted shape?
Often, yes. Implant removal combined with a lift can reshape the breast using your own tissue, though the breasts will be smaller.
Is revision riskier than the first operation?
Generally, yes. Scar tissue and a previously altered blood supply increase the risk of wound healing and nipple complications.
How many revisions can a breast safely have?
There is no fixed number, but each operation places more demand on the tissues. Mr Nassab will advise on what is safe in your case.
