Revision breast augmentation is surgery to correct or change the result of a previous implant operation. Common reasons include capsular contracture, implant rupture, a wish to change size, implants that have dropped or moved, rippling, or changes in the breasts after pregnancy or weight change. Revision is usually more complex than a first augmentation because of scar tissue and changes in the tissues, so careful assessment and planning are essential.
Why revision is needed
- Capsular contracture: the scar capsule around the implant tightens, causing firmness, distortion or discomfort.
- Rupture or implant concerns: a torn implant shell, or a wish to replace older implants.
- Size change: wanting larger or smaller implants, or removal altogether.
- Malposition: bottoming out, implants sitting too far apart, too close together (symmastia) or too high.
- Rippling: visible or palpable implant edges, particularly with thin tissues.
- Tissue changes: sagging or volume change after pregnancy, breastfeeding, weight change or ageing.
Some patients seek revision after surgery elsewhere, including abroad.
How long to wait
Unless there is an urgent problem such as infection, bleeding or a suspected rupture causing symptoms, it is usually best to wait at least six to twelve months after the original surgery. Tissues need time to soften and settle, swelling must resolve fully, and what looks like a problem at six weeks may improve by six months. After pregnancy or breastfeeding, waiting several months for the breasts to stabilise gives a more reliable basis for planning.
Assessment before revision
Mr Nassab will ask for details of your original operation, including implant brand, size and position, and a copy of the operation note and implant card if available. He will examine the tissue thickness, skin quality, capsule and implant position. An ultrasound or MRI scan may be arranged to check implant integrity. This information helps decide which of the available techniques will address your particular concern.
What revision can involve
- Implant exchange: replacing implants with a different size, shape or type; see breast implant exchange.
- Capsulectomy: removing part or all of the scar capsule, often for contracture or rupture.
- Capsulorrhaphy: internal stitching to tighten or reposition the pocket and support the implant.
- Pocket change: moving the implant from above to below the muscle, or the reverse.
- Adding a lift: an uplift where the breast has descended; see augmentation mastopexy.
- Removal: implant removal, with or without a lift or fat transfer.
What can and cannot be improved
Revision can often soften a hard breast, improve implant position, change size and restore a more natural shape. However, thin, stretched or scarred tissues set limits on what is achievable. Very large implants may have stretched the skin beyond the point where a smaller implant looks full. Some rippling can be reduced but not always eliminated. Recurrence of capsular contracture is possible even after careful surgery. An honest discussion of these limits is part of planning, and Mr Nassab will explain which aspects of your concern are likely to improve and which may only be partly corrected, so that you can decide whether further surgery is worthwhile for you.
Why revision is more complex
Each operation adds scar tissue, which makes dissection more demanding and can affect blood supply. Operating times are usually longer, the risk of complications such as seroma, infection and asymmetry is higher than after primary surgery, and more than one procedure may be needed to achieve the goal. Recovery is often similar in length to a first augmentation, but may be longer if a lift or capsulectomy is included.
Cost of revision
Because every revision is different, the price depends on what is needed. As a guide, a change of implants costs from £10,000 and from £13,500 with an uplift. Implant removal costs from £7,500 and from £11,500 with an uplift. The £150 consultation is separate. Surgery is for adults aged 18 and over. If you are researching surgeons, our article on choosing a breast augmentation surgeon may help.
Frequently Asked Questions
Is revision breast surgery riskier than the first operation?
It is generally more complex, and some complications are more likely because of existing scar tissue.
Can implants from another surgeon be revised?
Yes. Bring as much information as possible about the original surgery, including the implant details.
Is it essential to have the capsule removed?
Not always. It depends on the reason for revision, the condition of the capsule and scan findings.
How long is recovery after revision?
Many patients return to desk work after one to two weeks, but more extensive surgery may need longer.
Can implants be removed without replacement?
Yes. Removal can be combined with a lift or fat transfer to improve shape.
Should old implants be replaced if there are no problems?
Not automatically. Implants without symptoms do not always need changing, but a review and scan can help decide whether replacement is sensible.
