Breast augmentation revision surgery, also known as breast implant revision, is a secondary procedure performed to correct, improve, or update the results of a previous breast augmentation. While many women enjoy their initial results for years, circumstances can change. Revision surgery may become necessary due to medical complications, evolving aesthetic preferences, or simply because implants have reached the end of their functional lifespan.

Unlike a first-time breast augmentation, revision surgery presents unique challenges. The procedure often involves working with existing scar tissue, previously altered implant pockets, and changes in skin elasticity. These factors make revision surgery more technically demanding, requiring a surgeon with specialized training and extensive experience in both reconstructive and revision breast procedures.

When to Consider Breast Revision Surgery

Breast augmentation is rarely a one-time procedure. Most women with breast implants will need some form of revision surgery during their lifetime, whether for elective or medically necessary reasons. This could occur many years after the original augmentation when implants naturally age, or it might be required sooner if complications develop. Understanding the signs that indicate you may need a revision can help you make informed decisions about your breast health and aesthetic goals.

Common Reasons for Breast Implant Revision

Most women who choose breast revision surgery do so for one of three reasons: the age of their implants and natural changes over time, cosmetic preferences, or medical and structural concerns.

1. Implant Age and Natural Changes

While modern breast implants are designed for longevity, they are not considered lifetime devices. The U.S. Food and Drug Administration (FDA) notes that the longer a person has implants, the more likely they are to experience complications. On average, breast implants typically last between 10 and 20 years, although this is not a strict expiration date. Many women can keep their implants for longer without issue, and replacement is only necessary if problems arise or if the patient wishes to make a change.

It is essential to dispel the common misconception that all breast implants must be replaced every 10 years. There is no automatic expiration date. However, as time passes, both breast tissue and implants naturally change. Gravity, hormonal shifts, weight fluctuations, and the aging process can affect breast shape and position, potentially leading to rippling, shifting, or sagging.

Some women choose elective replacement once their implants reach the 10 to 15-year mark, even if no complications are present, to maintain their desired appearance and ensure implant integrity. Regular monitoring with a board-certified plastic surgeon is essential throughout the lifetime of your implants. For women with silicone implants, the FDA recommends screening with an ultrasound or MRI every 5-6 years to check for silent ruptures.

2. Cosmetic Preferences

Aesthetic goals can change significantly over time. What a woman wanted years ago may no longer align with her current lifestyle, body frame, or personal preferences. Many women decide to increase or decrease their implant size, adjust the shape or projection of their breasts, or switch from one implant type to another. For example, a patient might switch from saline to silicone implants for a softer, more natural feel, or opt for the newer cohesive gel implants.

Significant life events such as pregnancy, breastfeeding, or major weight loss can also alter the appearance of the breasts. When breast tissue stretches or thins, implants may shift position, resulting in mild sagging or asymmetry. In these cases, breast revision surgery can restore fullness and balance. Some women also combine a breast lift with their revision to enhance results and achieve a more youthful breast contour.

Additionally, some women seek revision to improve the appearance of scars from their initial augmentation. Even when a prior surgery heals well, incision lines can become more visible over time due to skin thinning, stretching, or changes in skin pigmentation. Modern surgical techniques can significantly reduce the visibility of scars and help them blend more naturally with the surrounding skin.

3. Medical or Structural Issues

In some instances, breast revision surgery is medically necessary. While some complications develop naturally over time or as the body changes, others may be related to surgical technique, implant placement, or variations in healing among patients. The most common medical issues that require revision include:

  • Capsular Contracture occurs when the scar tissue (capsule) that naturally forms around an implant hardens and tightens excessively. This can cause pain, firmness, or a distorted breast shape. While incidence rates vary, some studies suggest that approximately one in six breast augmentation patients may experience some degree of capsular contracture. Mild cases may not require surgery, but severe cases that cause discomfort or distortion typically necessitate capsular contracture correction surgery to remove or release the scar tissue capsule and often involve replacing or repositioning the implant.
  • Implant Rupture or Leakage can occur over time due to aging of the implant shell, injury, or everyday wear. A saline implant rupture is typically obvious, as the breast will quickly lose volume and deflate. A silicone implant rupture, however, may be a “silent rupture” with no immediate signs or symptoms. The FDA recommends regular screening with an ultrasound or MRI every 5-6 years for silicone implants to monitor for silent ruptures. In either case, breast implant replacement restores symmetry and comfort.
  • Implant Malposition or Shifting can occur when implants move from their intended position. This process can happen gradually as tissues stretch or thin, resulting in one breast appearing lower, higher, or further to the side than the other. Bottoming out (when the implant drops too low) and lateral displacement (when the implant shifts to the side) are common examples. Revision surgery repositions the implant and reinforces the implant pocket for improved symmetry and contour.
  • Visible Rippling or Wrinkling can occur when the edges of an implant become visible through the skin, particularly in patients with thinner breast tissue or those who have undergone significant weight loss. This can be corrected by switching to a different implant type, adjusting pocket placement, or using fat grafting to add soft tissue coverage and smooth the result.

Choosing a highly experienced, board-certified plastic surgeon significantly reduces these risks and helps ensure the best long-term results. Additionally, regular follow-up care and early evaluation of any concerns can help detect potential problems before they progress.

Signs You May Need a Breast Implant Revision

For many women, the decision to have breast augmentation revision surgery is personal and elective. Some choose it for aesthetic reasons, while others consider revision when their implants reach a certain age and they begin noticing changes in how their breasts look or feel. In some cases, however, revision surgery becomes medically necessary.

Common signs that you may need a breast implant revision include noticeable changes in breast shape, size, or position; one breast appearing higher, lower, or firmer than the other; persistent pain, tightness, or hardening in one or both breasts; visible wrinkling or rippling of the implant beneath the skin; changes in nipple position or symmetry; sudden loss of breast volume (more common with saline implants); or suspected or confirmed implant rupture or capsular contracture.

Even if you do not have signs or symptoms of complications, it is still essential to have your implants checked regularly. Regular monitoring and early intervention can prevent more serious issues and help maintain both your breast health and aesthetic results.

Types of Breast Revision Surgeries

There are several types of breast revision procedures, and the right approach depends on the patient’s specific needs and goals. Sometimes, a combination of techniques is used to achieve the best result.

  • Breast Implant Replacement: Also known as an implant exchange, this procedure involves removing the old implants and replacing them with new ones. This is common when implants are old, have ruptured, or when a patient desires a different size, shape, or type of implant.
  • Capsular Contracture Correction: This surgery is performed to treat capsular contracture. The hardened scar tissue capsule is either removed (capsulectomy) or released (capsulotomy), and the implant is often replaced or repositioned to restore a softer, more natural appearance.
  • Implant Malposition Surgery: This procedure corrects implants that have shifted. The surgeon repositions the implant and reinforces the implant pocket to ensure proper placement and symmetry. In some cases, an internal bra or surgical mesh is used to provide additional support.
  • Breast Revision with a Lift: A breast lift (mastopexy) can be combined with a revision to address sagging or stretched breast tissue. This is a common choice for women who have experienced changes due to pregnancy or weight loss, as it creates a more youthful breast position.
  • Fat Grafting: In this procedure, fat is taken from another part of the body via liposuction and injected into the breast area. Fat grafting can be used to smooth out visible rippling, improve cleavage, and create a more natural-looking contour.
  • Breast Implant Removal (Explant): Some women choose to have their implants removed permanently. This procedure, known as explant surgery, is often combined with a breast lift or fat grafting to reshape the natural breast tissue.

What to Expect During Breast Revision Surgery

Every breast revision surgery is tailored to the individual patient. However, the general process includes a consultation, the surgery itself, and a recovery period.

The Consultation

The first step is a consultation with a board-certified plastic surgeon who specializes in breast revision surgery. During this meeting, your surgeon will:

  • Review your medical history and discuss your goals and concerns
  • Examine your current implants and assess the condition of your breast tissue
  • Evaluate any complications that may be present
  • Explain the different types of revision procedures available
  • Recommend the best approach based on your anatomy and desired outcomes
  • Answer questions about the procedure, anesthesia, recovery, and potential risks
  • Provide realistic expectations for your results

If you decide to move forward, your surgical team will provide preoperative instructions, including guidelines on medications to avoid, fasting requirements, and how to prepare your home for recovery.

The Surgery

Breast revision surgery is typically performed as an outpatient procedure in an accredited surgical facility under general anesthesia. The surgical process includes:

Preparation:

  • Check-in and preoperative assessment
  • Treatment plan confirmation and incision marking
  • Administration of general anesthesia

Incision and Access:

  • Surgeon uses original incision sites when possible to minimize new scarring
  • Common locations include the inframammary fold (under the breast), around the areola, or in the armpit
  • Choice depends on your prior surgery and revision goals

Revision Procedure:

  • Existing implants are carefully removed or adjusted
  • Scar tissue or capsular contracture is addressed if present
  • Implant pocket is tightened, reshaped, or repositioned as needed
  • Excess skin is trimmed if a breast lift is performed
  • Nipple may be repositioned for a more youthful appearance

Implant Placement or Enhancement:

  • New implants are inserted into the refined pocket (if applicable)
  • Surgeon assesses symmetry, size, and projection
  • Fat grafting may be performed using liposuction from another body area
  • Purified fat is strategically injected to smooth contours and add volume

Closure and Recovery:

  • Incisions are closed with sutures
  • Surgical garment or supportive bra is applied
  • Small drains may be placed temporarily to prevent fluid buildup
  • Procedure typically takes two to four hours, depending on complexity
  • You are moved to recovery and monitored until you wake from anesthesia
  • Most patients return home the same day

Recovery and Results Timeline

Recovery from breast revision surgery varies depending on the complexity of the procedure. While a straightforward implant exchange may have a recovery period similar to or even shorter than the initial augmentation, more complex revisions may require a longer recovery.

Recovery Timeline:

  • First week: Downtime required before returning to work
  • 1-2 weeks: Light activities can typically be resumed
  • 4-6 weeks: Strenuous activities and heavy lifting should be avoided
  • 6 weeks: Most swelling resolves
  • 3-4 months: Breasts continue to soften and take on a more natural shape
  • 6 months to 1 year: Final outcome becomes obvious

Postoperative Care:

  • Follow your surgeon’s specific instructions for wound care and medications
  • Adhere to activity restrictions to reduce the risk of complications
  • Attend all follow-up appointments for monitoring
  • Report any unusual symptoms or concerns immediately

Long-Term Results: With proper care and regular monitoring, revision results can last many years. Thanks to modern implant innovations, many women can keep their implants for 15 to 20 years or longer without needing additional revision.

Choose The Lett Center for Your Breast Revision Surgery

Breast revision surgery is one of the most technically demanding procedures in cosmetic surgery, requiring advanced surgical skill, aesthetic precision, and extensive knowledge of both breast anatomy and implant behavior. At The Lett Center in Middle Tennessee, we specialize in complex breast implant revisions and reconstructive procedures.

Dr. Dwayne Lett is a double board-certified aesthetic and reconstructive plastic surgeon with decades of experience performing breast surgeries in Mt. Juliet and Lebanon, Tennessee. His dual certification in both general surgery and plastic surgery demonstrates mastery of complex surgical techniques and a deep understanding of both safety and aesthetics. This specialized expertise is essential for achieving optimal outcomes in revision cases, where working with existing scar tissue and altered anatomy requires exceptional skill.

Every breast revision procedure at The Lett Center is customized to your unique goals, anatomy, and lifestyle. Whether you are seeking implant replacement, size adjustment, complication correction, or complete removal, Dr. Lett will design a personalized treatment plan that restores your confidence and comfort while maintaining your long-term breast health.

If you are considering breast augmentation revision surgery in Nashville or the surrounding Middle Tennessee area, contact The Lett Center to schedule a private consultation. You will receive an honest assessment, expert recommendations, and compassionate guidance from one of Tennessee’s leading breast revision specialists.