Breast implant revision surgery is highly individualized. Some patients want their implants removed entirely, while others want to change their implant size, improve breast shape, correct changes that have occurred over time, or address concerns such as capsular contracture or implant rippling. The right approach depends on your anatomy, existing implants, breast tissue, and aesthetic goals.
Breast Implant Removal (Explant Surgery)
Some women decide they simply no longer want breast implants for various reasons. Others may experience discomfort, dislike their current appearance, develop capsular contracture, or prefer not to have a foreign body.
Explant + Capsulectomy
An explant removes the breast implants and can be performed alone or combined with other procedures. Depending on the condition of the capsule, or if you have severe capsular contracture (the scar tissue that naturally forms around an implant), a partial or total capsulectomy may also be appropriate.
Explant + Capsulectomy + Breast Lift
Because breast tissue and skin can stretch after years with implants, explant surgery may also be combined with a breast lift to reshape and reposition the remaining tissue.
Explant + Capsulectomy + Breast Lift + Fat Transfer
For patients who want additional natural volume after implant removal, fat transfer can be added to improve fullness and contour.
Breast Implant Exchange Surgery
Not everyone undergoing breast revision surgery wants their implants removed. An implant exchange replaces the existing implants with new ones.
Implant Exchange: Upsize, Downsize or Same Volume Swap
Patients may choose an exchange to go larger or smaller, change implant shape or feel, switch between saline and silicone implants, or address capsular contracture. Capsulectomy can also be performed when necessary.
Implant Downsize + Breast Lift
When downsizing significantly, a breast lift may be recommended because the existing skin may not contract sufficiently around the smaller implant. Again this can be combined with a capsulectomy if needed.
Implant Downsize + Breast Lift + Fat Transfer
Sometimes, patients want a smaller implant and need a lift as a result, but want fat also transferred to their chest and breast area to make a more seamless transition from the upper part of the chest to the breast area for the most natural results.
When the Implants Are Fine but the Breast Has Changed
Sometimes the implant remains in a good position while the natural breast tissue begins to sag over it. This can create what is sometimes called a waterfall deformity or Snoopy nose deformity.
Breast Lift (Mastopexy), with or without Implant Exchange
In these cases, a breast lift can reposition the breast tissue around the implant. Whether the implants should also be exchanged depends on factors including their age, condition, size, and the patient’s goals.
Fat Transfer
Fat transfer to the breasts can be a valuable addition to revision surgery. A patient’s own fat can help camouflage visible implant rippling, add cleavage-area volume, and create a softer, more natural transition between the upper chest and breast.
“Internal Bra”
For patients with very thin or significantly stretched tissues, additional internal support may also be considered. An internal bra or surgical mesh can help support the implant and reduce the risk of implant malposition, particularly when tissues are weak or implants are large and heavy.
Ultimately, breast implant revision is not one operation. It can involve explant surgery, implant exchange, breast lift, fat transfer, capsulectomy, internal support, or a carefully selected combination of these procedures. A personalized surgical plan allows each component to address a specific problem while working toward a balanced, natural-looking result.
Other Procedures:
Any of the above breast procedures can be combined with various other body contouring procedures in NYC. Namely, this can include Liposuction, Tummy Tuck, Arm Lift, Thigh Lift or any other body contouring or facial rejuvenation procedures.
Meet Dr. Brian Bassiri-Tehrani
Dr. Brian Bassiri-Tehrani is a double board certified plastic surgeon with extensive training and experience in complex breast revision surgery and body contouring in NYC. To see if you are a good candidate for any procedure, call (212) 540-6868, or click here to book a consultation.
