Implant Replacement  > Procedures

Secondary breast augmentation surgery may involve breast implant removal and/or implant replacement. Your surgeon will conduct a preliminary examination to determine the cause of your complications and advise a course of treatment for you.

What to Expect During Breast Implant Revision Surgery

During your initial breast implant revision examination, your surgeon will determine the cause of your problem and advise you on how to proceed. If you are having complications from scar tissue, you may be advised to have an implant revision, rather than removal or replacement, where your doctor will cut away the surrounding scar tissue, physically examine the implants, and leave them in place. If you are having complications from improper positioning or defective implants, you may be advised to have the implants removed, and possibly replaced with new implants.

Breast augmentation revision is similar to breast augmentation. General anesthesia is used during secondary breast augmentation. Implant revision or removal may require less time than implant replacement because there are fewer steps involved, but most secondary breast augmentations take less then an hour to complete.

Most patients will be kept under observation for three to 24 hours after breast implant revision surgery. Patients will be on bed rest for two to three days after surgery, and may return to work in one to two weeks. Strenuous exercise and heavy lifting should be avoided for four to six weeks.

Breast Augmentation Revision Options

Your breast implant revision options will be dictated by the complications you are having with your implants. Complications may arise from the size, shape, texture, or positioning of the primary implants. Your surgeon will advise you on how to best proceed with your breast augmentation revision. Choosing the correct type of breast implant, the proper shape and texture, and the proper placement technique are all important factors in avoiding the need for breast implant removal surgery.

Saline vs. Silicone Implants

If you were unsatisfied with the results of your original breast implant surgery, choosing a different type of implant may make all the difference. Women who are deciding between silicone and saline implants for their breast implant replacement surgery should make an informed decision after considering the risks and benefits of each, and their own cosmetic goals.

Many women prefer silicone over saline implants because they look and feel more like natural breasts. Silicone implants were removed from the market in 1992 in order for research studies to be conducted on their safety. In 2006, after reviewing extensive data, the FDA approved silicone implants made by two companies, Allergan Corp. and Mentor Corporation.

Women requiring breast implant replacement surgery following the rupture of silicone implants should have surgery performed immediately because silicone may be harmful if it spreads through the body. While studies are currently being done, health risks associated with the leakage of silicone are still unknown. However, once the leaked silicone is absorbed into the body, it travels to the organs and the lymph nodes and is impossible to remove. Since the thick gel in silicone implants leaks slowly, it may take months or years for a woman to notice a change in the shape or size of her breast. For this reason, a woman with silicone implants should have MRIs to check for leaks within three years of her surgery and every two years after that. Aside from the potential risks associated with silicone leakage, the implants are safe, and most patients who have chosen silicone implants have been satisfied with the results.

Saline implants are another natural-looking option for implant replacement, and are considered easier to replace than silicone implants if a complication arises. However, neither saline nor silicone implants have a higher incidence of requiring replacement surgery. When saline implants rupture, the fluid leaks out quickly, making it apparent that a rupture has occurred. Saline implants do not pose a health risk if leakage occurs, except in rare instances when the saline is contaminated with bacteria or mold. The major drawback of saline implants, because they are filled with a salt-water solution, is that they tend to show rippling more than silicone gel breast implants. This is particularly true for thin women who have less breast tissue to cover the implants. It is important to speak with your surgeon when deciding which type of implant is most appropriate for your breast implant replacement surgery.

Smooth vs. Textured Implants

Before your breast implant replacement surgery, you will have to choose the surface texture of your new implant.

Textured implants were originally designed to prevent capsular contracture from occurring, though there has been no evidence that they are less prone to being damaged by scar tissue. Because textured implants do not move inside the surrounding pocket of tissue, they can resemble more anatomical breast shapes. Textured implants, however, are more likely to wrinkle and pucker, particularly in women with thin skin that is easier for the implant shell to pull. Textured implants are often more difficult to remove during breast augmentation revision surgery because they become attached to the surrounding tissue.

Smooth implants tend to have thinner shells and can move freely within the breast pocket. Anatomical teardrop shaped implants are not made with smooth shells because the moving and shifting of the implant would result in the implant folding over. Smooth implants are often used to replace textured implants in instances where the textured implant has wrinkled or buckled.

Round vs. Teardrop Implants

Before your breast augmentation revision, if you are choosing implant replacement, you will need to decide the shape of your new implant. Round implants produce a natural looking breast for most women, and are the preferred option. Women who need breast implant revision due to the wrinkling or folding of a textured implant will most likely require a smooth round implant if they choose to replace the first one.

Women who require anatomical teardrop shaped implants are usually those with very little breast tissue, for whom a round implant would appear unnatural.

Small vs. Large Implants

Size matters with breast augmentation revision, and choosing the wrong size the first time around is often the cause for breast implant revision or replacement. Your doctor can advise you regarding the size that would be anatomically proportional to the rest of your body, which is usually the best choice.

Choosing more conservatively sized breast implants usually results in fewer complications and less chance of needing breast implant revision, though some women may choose to undergo breast implant replacement if they still feel that their breasts are too small.

Choosing large sized breast implants creates a higher risk of complications, which may result in the need for breast implant revision or replacement. Some women may also find their new large breasts to be obtrusive in their daily activities, or unnatural looking, which may also prompt a secondary breast augmentation.