Revision after Motiva Preservé may be needed for reasons such as capsular contracture, implant malposition, a wish to change size, asymmetry, rupture or changes after pregnancy or weight loss. Unless there is an urgent problem, it is usually best to wait at least six months, and often longer, for the tissues to settle. Revision is more complex than first-time surgery and may not use the same minimally invasive approach.
Why revision is sometimes needed
- Capsular contracture: the scar capsule around the implant tightens, making the breast firm, high or uncomfortable.
- Malposition: the implant sits too high, too low or too far to the side, or the breasts are uneven.
- Size change: some patients later wish to go larger or smaller.
- Rippling or visibility: the implant edge can be felt or seen, particularly where tissue cover is thin.
- Rupture or implant concerns: including a scan showing a problem, or symptoms you attribute to the implants.
- Life changes: pregnancy, breastfeeding, weight change and ageing can alter how the breasts sit over the implants.
How long to wait
In the early weeks the breasts often look high, firm and uneven while swelling settles and the implants drop. This is normal and not a reason for revision. Mr Nassab usually recommends waiting at least six months, and up to a year for concerns about shape or size, so that the final result can be judged. Earlier surgery is only advised for problems such as a haematoma, infection or wound breakdown, which are managed urgently.
What revision can improve
Depending on the problem, revision may involve removing a tight capsule (capsulectomy), repositioning the pocket with internal stitches (capsulorrhaphy), moving the implant to a different plane, exchanging the implant for a different size or profile, or adding a lift where the breasts have dropped. Where cover is thin, fat grafting can sometimes be used to improve softness over the implant edge. Options are tailored to the findings at examination and sometimes to a scan. For more on the procedures used, see breast implant exchange and breast implant removal.
What revision cannot always fix
Revision can often improve problems, but it has limits. Thin skin and tissue may not provide enough cover to hide an implant fully. Stretch marks and loose skin cannot be removed by changing implants alone. Contracture can recur. Very large implants may have stretched the tissues in ways that cannot be fully reversed. An honest discussion of what is realistic is central to the consultation.
Why revision is more complex
Scar tissue from the first operation changes the anatomy, blood supply and tissue planes. The surgeon may need a longer incision than was used for Preservé, and it is not always possible to keep to the same minimally invasive principles. Revision often takes longer, is more likely to need a general anaesthetic and may involve a drain. Recovery can be a little slower than after the original surgery, and the risk of further complications is higher.
Removing implants altogether
Some patients decide they no longer want implants. Implant removal, with or without the capsule, is an option, and a lift may be advised if the breasts are likely to look deflated afterwards. Implant removal is from £7,500 (from £11,500 with an uplift). Change of implants is from £10,000 (from £13,500 with an uplift). The £150 consultation is separate.
Revision for surgery performed elsewhere
Mr Nassab also sees patients whose original surgery took place elsewhere, including abroad. Bring any records you have, including your implant details or registry card, so that the new plan can take account of what was done.
Frequently Asked Questions
Can revision be done through the Preservé incision?
Sometimes, particularly for a simple exchange. More complex revisions may need a longer incision to allow safe access.
Is capsular contracture a reason for revision?
Yes, if it causes firmness, pain or distortion. Surgery usually involves removing or releasing the capsule and often replacing the implant.
How much does revision cost?
Implant exchange is from £10,000 (from £13,500 with an uplift). Other revisions, such as capsulectomy with pocket repair, are quoted at consultation.
Is recovery longer after revision?
Often slightly longer, especially if a capsule is removed or a lift is added. Mr Nassab will give you a personal timeline.
Can patients from other clinics be seen?
Yes. Bring your operation notes and implant details if available.
Should a scan be done before revision?
An ultrasound or MRI scan is sometimes helpful, for example if rupture is suspected or there is late swelling. Mr Nassab will advise whether imaging is needed in your case.
