Even though you were happy with your breast augmentation, over time your breasts and implants will change. You may develop rippling in the implant, implant rupture, capsular contracture, or sagging breast tissue due to age, weight changes, or childbirth. Some women would prefer to change the look of their breasts, either wanting their breasts larger or smaller. Regardless of the reason you would like to revise your breast augmentation, there are many different options for you to choose from.

1. Am I a good candidate for breast revision?

If you are healthy and have realistic expectations for your results, then breast augmentation revision is a good option. We may ask for medical clearance from your primary care doctor, EKG, labs, and a mammogram. If there is a question of your implant being ruptured, we may ask for a breast MRI.

2. What Are the Different Options for Breast Implant Revision?

Often the first question is does a woman want to have larger or small breasts? Most women prefer to go through their existing incisions to avoid creating new scars on the breasts. Some women may need to do a breast lift if they choose to go with a smaller implant or if they have developed a large amount of sagging breast tissue.

Options available for implants include silicone and saline, and within those choices there are several different shapes and profiles. There are “tear-drop” shaped silicone implants with a variety of different heights and profiles and round implants with many different profiles. The type and shape and profile of implant will be determined by the “look” a woman wants to achieve.

3. Can I change my implant size or type with implant revision surgery?

Yes, many women use a revision surgery to change from saline to silicone implants. Also, if a smaller breast is desired, a breast lift can be performed. A larger implant, if it fits your body structure, is usually a straightforward procedure.

4. How can I tell I my implants need to be replaced?

Saline implants deflate once they are ruptured. The saline is absorbed back into the body. Silicone implants can also rupture, but it is not usually as obvious and a breast MRI is usually needed for a definitive determination.

5. Will my capsular contracture come back again?

About 5%-8% of breast augmentation patients develop capsular contracture and reports of about 40% of these women develop recurrence. This usually occurs within a few months of implantation but can occur at any time. It is unknown what causes a “silent” capsular contracture, which means a contracture that develops without injury or hematoma. One theory is a low-grade infection at the time of implantation. The current treatment is removal of the scar tissue around the implant and replacement of the implant. Dr. Samimi uses careful, sterile techniques and washes the implants and breast pockets with cleanser and antibiotics to prevent recurrence of the contracture. In severe cases, an acellular dermal matrix can be used to reinforce the pocket and reduce recurrence by 0.6%-6.3%. Additionally, medication such as Singular has been found to help reduce the likelihood of development of contracture.

6. What is “double-bubble” and how can it be treated?

Women with constricted breasts, who are implanted with a too large implant, or with poorly defined breast folds can develop implant migration under the breast fold. This stretching of breast fold creates a lower bulge under the fold and an upper bulge above the crease from natural breast tissue, or “double-bubble”. If the ‘double-bubble” is the result of an overly large implant, replacement with a smaller implant may correct the deformity. However, women with severe implant slippage may require an inframammary fold revision. This can be a challenging procedure as the body wants to retain its original contours.

7. Will I have more scars after breast augmentation revision surgery?

Dr. Samimi always looks for the procedure that will give a woman the look that they are seeking with the least number of scars as possible. If you need a breast lift, you will need to have additional scars on your breasts. A consultation will help determine the best course of treatment that most realistically meets your goals.

8. Can I have my breast implants completely removed?

Yes, you can choose to have your implants removed. There is several different surgical options to help achieve an esthetic outcome {link to breast implant removal}

9. Will I need more than one procedure to see the best results?

There is always the possibility of needing more than one procedure to achieve your esthetic goals. As long as these expectations are realistic, Dr. Samimi may suggest modifying results with fat injections, lateral chest liposuction and or scar revisions.

10. What will my recovery be like?

Your recovery will be similar to your primary augmentation. Depending on the exact procedure, you may require drains. Please avoid lifting anything more than 10lbs for about 2 weeks. Compression will help your implants heal in the correct position.

11. What Are the Possible Side Effects of Breast Implant Revision?

Possible side effects include a recurrence of capsular contracture, hypertrophic scarring, asymmetry, and decreased or loss of sensation. Breast fold modifications are especially challenging and may result in implant slippage.

12. Will Insurance Cover Breast Implant Revision?

Generally, if an implant was placed for cosmetic reasons, insurance will not cover revision. Some insurance plans may cover the removal of a breast implant and capsular contracture, if it is deemed to be medically necessary. However, insurance will not cover breast lifts, or breast implant replacement. This is considered cosmetic and not medically necessary.