Revisional Breast Implant Surgery


  • Removal and Replacement of breast implants Expert

  • Over 20 yrs experience

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Breast Reduction Sydney cosmetic surgeon plastic surgeon cosmetic surgery 

Good things don’t last forever!  Breast implants are well made and problems with them are unusual.

There is a chance over time however, that problems may develop with breast implants and removal and replacement of your breast implants may be required or preferred.

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Reasons why women with breast implants may need or want to have them replaced include:

  • wanting to go smaller
  • wanting to go bigger
  • capsular contracture or scarring around implants
  • implant rupture or leak
  • displacement of implant causing breast distortion
  • rippling of implants
  • slippage of implants to low position
  • breast sag or droop off implants (requiring a lift)
  • original surgery was not done satisfactorily

Wanting to go bigger

Most women are very happy with the implant size they choose, with the help and advice of their surgeon. Some women however become disappointed or unhappy with their breast size and in Dr Drielsma’s experience, it is almost always that they wished they had chosen a bigger size. Dr Drielsma is very aware of this and when advising his patients having breast implants usually recommends a bigger size if any uncertainty or confusion exists. Changing breast implants for bigger ones is actually the most common reason for removal and replacement of breast implants surgery.

Wanting to go smaller

Fashions change and there is an international trend away from “fake big boobs” to a smaller natural look. Dr Drielsma Uses smaller anatomical shaped implants to give a natural look. Downsizing may also best be combined with breast lifting to tighten the breast and place the nipple back in the correct relationship with the implant.

Woman who have had their implants in their 20’s may find in their 30’s and 40’s after having their kids that the breasts are on the large side with sagging. The combination of a breast lift with removal and replacement of breast implants is the best option.

Operating Time:2 Hours
Hospital Stay:1 Night
Recovery Time:Approx. 2 weeks

Capsular contracture or scarring around implants

Apart from wanting to go bigger, capsular contracture is the most likely reason women with breast implants may one day require a further  surgery to replace them. Capsular contracture is the build up and thickening of scar tissue around the implants that over time can lead to hardening or distortion in breast shape. Capsular contracture is generally takes years to develop and typically becomes a problem towards the 10 year mark after initial surgery.

The incidence of capsular contracture is around the 5% mark over 10 years.   Patients who develop problematical capsular contracture with hardening of implants, distortion of breast shape or breast pain will usually want to have removal and replacement of breast implants. This involves having the implants removed,  scar tissue released or removed, and implants replaced. It may also require reconstructive procedures, breast lifting and possibly fat grafting to the breast.  Dr Drielsma may discuss or recommend the use of poly-urethane implants to replace those that have undergone capsular contracture.

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Implant rupture or leak

Modern breast implants are very well made. Dr Drielsma only uses high quality cohesive gel textured implants or poly-urethane implants.  All implants are man made devices however and there is a known incidence or implant rupture over time. The incidence of implant rupture is around 5% over 10 years. Cohesive gel implants don’t “leak” like older liquid gel implants were prone to do.  If a cohesive gel implant ruptures in a minor way (pin hole or tiny tear) you may not even realise. With a more serious rupture, which may occur spontaneously or following trauma, distortion or symptoms like pain and discomfort may be noted. If rupture is suspected, an x-ray (ultrasound or MRI scan) will usually be arranged. If you have a ruptured breast implant, removal and replacement will be recommended.

Dr Drielsma recommends that an ultrasound examination to all patients with breast implants be done some 8 to 10 years after their insertion even if there are no problems.

Displacement of implant causing breast distortion

Over time, in some cases, capsular contracture as described above could lead to breast implants shifting to abnormal positions causing distortions of breast shape. Revisional surgery whereby implants are removed,  implant pockets are repaired and reshaped and new implants re-inserted may be required.

Rippling of implants

Minor rippling of implants, noticeable as shadowing in certain lights or visible and palpable irregularities can be noticed following breast implant insertion. Usually these issues are minor and only noticed by the patient, not by others. Dr Drielsma generally advises his patients in this situation not to intervene as further surgery is not warranted. Severe visible rippling or implant edge palpability may in some cases warrant revisional removal and replacement of implants.

Slippage of implants to low position

Very uncommonly, some patients experience a downward migration of their breast implants to a lower than ideal level. In such cases, re-operative surgery to repair the tissues at the lower crease of the breasts may be required.

Breast sag or droop off implants

Over time, or following weight loss or pregnancy, the breast may descend lower and hang down off breast implants. In this situation, breast lifting is likely to be recommended. Removal and replacement of breast implants will usually be involved with such breast lifting surgery.

Original breast augmentation surgery was not satisfactory and results unacceptable

If the breast augmentation had bad results that are unacceptable the revisional surgery will be required.

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