Revising an Augmentation

iStock 157770095 Breast augmentation isn’t a perfect science, and there are times when a patient desires implant revision surgery. Whether she decided she would simply like larger implants or whether there has been some other issue, revision surgery is generally easier than the original surgery. This is because in most cases the incisions can be made along the original incision locations. 

Here are some reasons Dr. Smith performs revision surgery, and the approach taken for each. 

  •     Changing the implant size

Sometimes a woman decides she would like a different size implant. This isn’t a decision that should be made soon after surgery, however. Dr. Smith generally advises patients to wait one full year before deciding to make a change. This will allow the implants to fully settle into their final position, and any residual swelling will have passed by then. If the patient still wants to change her implant size, Dr. Smith will enter through the original incisions. If a larger implant is desired, he will increase the size of the pocket, the space in the breast to hold the implant. If the patient seeks smaller implants, the size of the pocket is reduced with sutures to fit the smaller implants. In cases of reduction, a breast lift may need to be done in conjunction with the implant revision to remove any sagging tissue and possibly relocate the nipples. 

  •     Capsular contracture

The main complication with breast augmentation is capsular contracture. The formation of scar tissue is the body’s reaction to having an implant placed. The same happens when an artificial knee or any other prosthetic is placed. In the breasts, the scar tissue around the implant is called the “capsule” and it is made up of calcified cells and scar tissue. If this capsule becomes very thick and causes the implant to shift or the breast to feel very firm, or if there is pain from the constricting scar tissue, this is called capsular contracture. When this occurs, surgery is required. If the capsule is very calcified, Dr. Smith will remove it along with the implant. If that hasn’t happened, he may leave the capsule. If there is a rupture of a silicone implant, the capsule may contain silicone shell fragments, silicone gel, and inflammatory cells that all need to be removed prior to placing new implants. 

  •     Implant removal

Some women decide to remove their implants. This is especially true as a patient reaches older ages and doesn’t want to deal with the increased looseness that is occurring with her breast tissue and how it will impact her implants. Implants are removed through the same incisions as used to place them. Dr. Smith will also remove the capsule if it is calcified and thick. In most cases, he will recommend a breast lift at the same time to remove excess sagging skin and breast tissue that were created with the larger breasts when they had implants. 

  •     Implant position

Sometimes a less experienced surgeon will place the implant pockets either too far away or too close together and the patient doesn’t like the look. In these cases, the scar tissue from the capsule can be used to reconstruct new pockets in better positions. 

  •     Implant rippling

Implant rippling is usually a result of saline implants that have been placed atop the chest muscle. There isn’t enough skin and tissue to cover the implant, and rippling occurs. Dr. Smith enters through the original incisions and replaces the implants with better muscle coverage. This may involve switching implant types and/or placing them in new breast pockets. Saline gel implants have less occurrence of rippling. 

As a double board-certified general and plastic surgeon with decades of experience, Dr. Smith is the perfect choice to help you with any revision surgery needed. Call us at (843) 705-8940 to schedule a consultation.


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