Breast Implant Revision

Breast implants are not considered to be lifetime devices. A breast implant revision, or secondary breast augmentation, is performed to replace the implants and/or address changes or complications to your breasts.

Why Consider Breast Implant Revision?

Patients undergo a revision breast augmentation to either address complications or refresh aesthetic results. The most common motivations include:

• Size or style update: Switching to a different volume, profile, or gel consistency for better proportions or feel.
• Device issues: Rupture, deflation, or visible rippling.
• Capsular contracture: Tight scar tissue that hardens or distorts the breast.
• Malposition or “bottoming-out”: Implants that move from their original position.
• Breast tissue changes: Pregnancy, weight shifts, or aging that create sagging or asymmetry.
• Animation deformity: Unwanted implant movement with chest-muscle flexion, often after subpectoral placement.

Who is a Candidate?

You are likely a good candidate if you:

• Are healthy and a non-smoker
• Have realistic expectations and a specific concern, cosmetic or medical, to address
• Understand that revision is more individualized (and sometimes more complex) than a first augmentation

Meeting with a cosmetic surgeon to discuss your individual case is an important first step in understanding whether breast implant revision is right for you at this time, as well as the unique surgical plan required in your case.

What Happens During Surgery: Revision Technique Options

Breast implant revision is tailored to address your concerns, whether that is updating your look, resolving complications, or simply removing your implants altogether. The techniques used, as a result, can vary widely.

Implant Exchange

If you are happy with breast implants but want a different size, shape, or type of implant, your surgeon can remove your current implants and replace them in a single operation. Implant exchange is relatively straightforward, often using your original incision sites to minimize new scarring. 

Recovery generally mirrors your first augmentation, as most patients resume normal activities in a few days and exercise within two to four weeks, depending on the guidance you receive from your surgeon.

Best for:

• Desire to go larger or smaller
• Switching from saline to silicone (or vice-versa)
• Updating aging implants without other complications

Capsulectomy

A capsulectomy removes some or all of the scar tissue capsule that naturally forms around every implant. This is typically performed if capsular contracture has made the breasts feel firm, distorted, or painful. 

Total capsulectomy involves excising the entire capsule; partial capsulectomy removes only the problematic portion. Because this technique requires meticulous surgical skill, operating time is longer and recovery may include more swelling or bruising. Most patients can expect two to three weeks of modified activity before returning to their full routine.

Best for:

• Capsular contracture (Grades III-IV)
• Implant rupture with concerns about the integrity of silicone-filled implants

New Implant Placement

Breast implants may be placed under the muscle (submuscular), above the muscle (subglandular), and beneath a thin fascia layer above the muscle (subfascial). Changing the placement of the breast implant pocket means moving an implant that was, for example, under the pectoral muscle to a subfascial or subglandular plane—or vice-versa. 

Changing the placement can correct animation deformity, when the implant visibly moves when you flex your pectoral muscle, or visible rippling, when the implant’s surface is visible beneath the skin. Or, it may be recommended by your surgeon based on your unique concerns and lifestyle.  Submuscular placement offers added soft-tissue coverage, while subfascial/subglandular placement eliminates muscle movement over the implant and may speed recovery. 

Expect a slightly longer surgery than simple exchange, with recovery similar to your initial augmentation; chest muscle repositioning may increase post-op soreness for submuscular implant exchanges.

Best for:

• Visible rippling in thin tissues
• Implants that move with chest-muscle activation
• Desire for softer upper-pole fullness

ADM (Internal Mesh)

Acellular dermal matrix (ADM), sometimes called an “internal bra,” is a biocompatible mesh that reinforces weak tissues and helps stabilize the implant pocket. Your surgeon sutures the mesh inside the breast to support implants, reduce recurrent sagging, and correct bottoming-out or lateral implant drift. 

Because ADM requires additional materials and surgical steps, expect a longer operative time and slightly higher cost. Recovery parallels other pocket-reinforcement procedures, but wearing a supportive post-surgical bra is crucial while the ADM integrates with your tissues.

Best for:

• Recurrent implant malposition (bottoming-out, “double-bubble,” or lateral slide)
• Thin or stretched tissues after weight changes or pregnancies
• Revision after massive weight loss or multiple prior surgeries

Fat Grafting

Using liposuction, your surgeon harvests fat from areas such as the abdomen or flanks, processes it, and injects it around the implant or into the breast once implants are removed. Fat grafting can camouflage minor rippling, correct contour irregularities, or add subtle volume without a larger implant. 

Because transferred fat needs time to establish its own blood supply, expect two recovery sites: the breasts and the liposuction areas. Swelling and mild soreness last about one to two weeks, and final results appear after about six months once the fat that “takes” becomes permanent.

Best for:

• Smoothing edges or ripples in thin tissue
• Enhancing cleavage or upper-pole fullness without upsizing the implant
• Natural-feeling volume in combination with implant removal

Breast Lift Combination

When sagging skin or tissue laxity contributes to dissatisfaction with your implants, a breast lift (mastopexy) can be combined with exchange, repositioning, or explant to restore a youthful breast shape. 

A lift involves removing excess skin and reshaping the breast, often relocating the nipple-areola complex higher on the chest. Combining procedures extends operating time and recovery, but it avoids multiple recoveries and can provide an optimal result when performed by an expert surgeon. 

In order to reshape the breast, breast lifts involve incisions placed around the areola and often extending down to the lower breast fold (inframammary fold). Patients may also experience a longer healing period of about four to six weeks before high-impact exercise can be resumed.

Best for:

• Significant ptosis (sagging) around existing implants
• Desire to maintain volume while improving breast position and firmness
• Restoring symmetry after pregnancy, weight fluctuation, or aging

Explant

Choosing to remove implants permanently, a procedure called an explant, may be driven by lifestyle changes, aesthetic preference, or medical concerns such as implant rupture or breast implant illness (BII). 

Explant surgery can be as simple as removing the implant alone, though some cases require a complex technique such as an “en bloc” capsulectomy with lift and fat grafting to create the optimal post-op contour.

Recovery is usually shorter than augmentation, but final breast shape depends on skin elasticity, previous implant size, and whether a lift or fat grafting is performed at the same time.

Best for:

• Personal preference to return to an implant-free chest
• Implant rupture or chronic discomfort
• Concern about systemic symptoms possibly related to implants

A board-certified cosmetic surgeon will recommend one or more of the techniques above based on your anatomy, goals, and the condition of your existing implants and breast tissues.

Recovery & Expected Results

In the first few days, expect mild tightness. You will likely have prescription pain control and be asked to wear a surgical bra. Most patients return to non-strenuous work after a week. Bruising and swelling will continue to improve after that, and most patients are cleared to resume exercise and heavy lifting after 4-6 weeks. Implants placed below the muscle will “settle” after 3-6 months or longer, revealing final results.

Following all post-op instructions—including support garment use when advised, and avoiding over-exerting yourself—helps you to optimally heal and achieve stable results.

Frequently Asked Questions