Breast Revision Surgery Plastic Surgeon Wollongong & Sydney

Existing implants may be replaced with implants of a different size, shape or profile. An implant exchange may be considered when an implant has ruptured, the current implants no longer suit the patient, or a different breast proportion is preferred.

Changing implant size does not always involve a straightforward exchange. A significant increase or decrease may also require changes to the implant pocket or breast skin.

The implant pocket is the space created inside the breast to hold the implant. If an implant has moved too low, too far to the side, or towards the centre of the chest, the pocket may need adjustment.

This can involve tightening part of the pocket, changing its position or providing additional internal support where appropriate.

A layer of scar tissue, known as a capsule, naturally forms around every breast implant. In some patients, the capsule becomes thick or tight and changes the feel, position or shape of the breast.

Depending on the findings, the capsule may be released, partially removed, or removed more extensively. Total capsulectomy is not automatically required for every breast revision procedure.

Implant replacement alone may not correct loose skin or a low nipple position. In these circumstances, a breast lift may be considered to remove excess skin and reshape the remaining breast tissue.

A breast lift creates additional scars, so that we will discuss the potential benefits and limitations during consultation.

Fat transfer uses fat collected from another area of the patient’s body to add modest volume or soften selected contour differences around the breast.

It may be used as part of revision surgery, but it cannot always replace the volume or projection an implant provides. Not all transferred fat will remain permanently, and additional treatment may occasionally be considered.

Some patients decide that they no longer want breast implants. Implant removal may be performed alone or combined with a breast lift, capsule surgery or fat transfer, depending on the breast tissue and the patient’s preferences.

General anaesthesia carries its own risks, including reactions to medicines and breathing or heart problems. The anaesthetist will assess these risks before surgery.

Blood clots can form in the deep veins of the legs (deep vein thrombosis) and may travel to the lungs (pulmonary embolism), which can be life-threatening. Measures to reduce this risk are planned according to individual risk.

Pain or discomfort in the breasts, chest or around the scars usually improves as healing progresses, but it may persist for several months and, in some patients, may be long-term.

Previous surgery can affect the blood supply to the breast skin, fat, nipple and areola. If the blood supply is reduced, areas of skin or breast tissue, or part or all of the nipple and areola, may heal poorly or not survive. This may require prolonged wound care or further surgery. The risk may be higher when the tissues are thin, when a breast lift is combined with implant surgery, or in patients who smoke or have certain medical conditions.

Additional risks depend on the techniques included in your revision. Releasing or removing the capsule can increase the risk of bleeding and fluid collection; because the capsule can sit against the chest wall, removing it may rarely injure the chest wall or lung lining (pneumothorax). A breast lift creates additional scars and can cause wound breakdown, changes in nipple sensation, reduced ability to breastfeed and partial or complete loss of the nipple and areola. With fat transfer, not all transferred fat survives, which can cause firm lumps (fat necrosis), oil cysts or calcification that may need breast imaging or further assessment, and additional treatment may be needed to reach the planned volume.

Replacement implants, like all breast implants, are not lifetime devices. There is no fixed replacement date, but you will likely need further surgery to revise, replace, or remove the implants at some stage. Ongoing breast checks and any recommended imaging remain important after revision surgery.

Implant-related complications can also occur after revision surgery. The implant shell can rupture, which may cause no symptoms and may only be found on breast imaging. Capsular contracture can recur even after treatment, causing firmness, discomfort, or a change in breast shape. The implant can move from its intended position, sitting too low, too far to the side or towards the centre of the chest. If the skin or tissue covering the implant breaks down, the implant can become exposed, which usually requires further surgery and may require implant removal.

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare cancer of the immune system that can develop in the fluid or scar tissue around a breast implant. It is not a cancer of the breast tissue itself. BIA-ALCL has been associated mainly with textured implants and most often appears years after surgery as new swelling or a lump in the breast. When diagnosed early, doctors usually treat it by removing the implant and the surrounding capsule.

Other rare cancers, including squamous cell carcinoma and other lymphomas, have also been reported in the capsule around breast implants. If you notice new swelling, a lump, pain or any other change in the breast at any time after implant surgery, contact Dr Barker or your general practitioner for assessment.

The risks relevant to your proposed operation will be discussed during consultation and through the formal informed-consent process.