What is Breast Implant Revision?

Breast implants are commonly used in the United States, and throughout the world, for breast augmentation and reconstruction. Changes in the appearance of the breasts after augmentation or reconstruction can occur with pregnancy, weight fluctuations, normal aging, and menopause. Some of the reasons that women seek breast implant revision include desire for implant size change, implant deflation or rupture, capsular contracture, and asymmetry.

You are a good candidate for breast implant revision surgery if you have breast implants and dislike something about the way they look and/or feel. When choosing to undergo breast implant revision surgery, there are many factors to consider. It is important that you feel extremely comfortable with your surgeon. Dr. Hewell and/or Dr. Fischer will spend a significant amount of time with you preoperatively discussing implant safety, anesthesia choices, and revision options to ensure an excellent result.

About the Procedure:

The procedure starts with accurately diagnosing the problem with your existing implants. Dr. Hewell and/or Dr. Fischer spend a significant amount of time with every patient to perform a physical examination, discuss implant choices, and to understand each patient’s current concerns with the patient’s existing implants. When selecting a surgeon for breast implant revision surgery, it is important that you feel confident with the surgeon and the surgical plan.

The revision procedure performed will depend on the current concerns with the existing implants. Some examples of common revision procedures include implant exchange to increase or decrease the size of existing implants, implant exchange to replace one or both implants due to deflation/rupture, implant capsule work to alter the pocket that the implant sits in, moving the implant from above the muscle to under the muscle (or vice versa), removing existing breast implants without replacement, and fat grafting to the breasts to help with implant visibility/rippling. The correct surgical procedure for you will be discussed at your consultation.


Saline implants are silicone shells filled with sterile salt water. If a saline implant leaks, the implant will collapse and the salt water is naturally absorbed/expelled from the body. Saline implants are FDA-approved for augmentation in women age 18 or older.

Silicone implants are silicone shells filled with silicone gel. Some women prefer silicone gel implants, as the gel is soft and can feel more like breast tissue. If the implant leaks, the gel may remain within the implant shell or may escape into the breast implant pocket. Unlike a saline implant, a leaking silicone gel implant will not collapse. Ultrasound or MRI can be used in the postoperative period to assess the integrity of the implant if concerns arise. Silicone implants are FDA-approved for augmentation in women age 22 or older.

Structured saline implants are a newer type of breast implant that were developed to blend the beneficial properties of saline and silicone gel implants. These implants are filled with saline but have nested silicone shells to give the saline implant a more natural feel.

Breast implants can be shaped or round. Shaped implants, often referred to as form-stable, or “gummy bear” implants have more projection at the bottom and are tapered towards the top. These implants are meant to sit within a breast pocket and not rotate to maintain the projection at the bottom. All shaped implants have a textured (fuzzy) surface to help the implant stick in the breast pocket in the proper orientation. Round implants are round in shape and there is no concern about rotation as there is no distinct top/bottom to the implant.

Smooth breast implants have a smooth shell, which allows the implant to move with the breast. Women report that this gives the breast a natural feel and movement. Textured implants have a fuzzy shell, which causes them to stick to the breast implant pocket. Due to current concern for anaplastic large cell lymphoma (ALCL) with textured breast implants, Dr. Hewell and Dr. Fischer prefer to use only smooth breast implants.

Breast implant revision surgery can be safely performed in an accredited office-based surgical facility. Dr. Hewell and Dr. Fischer’s office ambulatory surgical facility is accredited by the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF). Established in 1980, AAAASF holds outpatient and office-based facilities to hospital standards and assures the public that patient safety is the top priority in a facility.

Medications are administered for your comfort during the surgical procedure. Anesthesia choices for breast implant revision surgery include intravenous sedation and general anesthesia. Dr. Hewell and Dr. Fischer will recommend which anesthesia option is best for you.

Yes, breast implant revision surgery can often be performed at the same time as breast lift surgery. Dr. Hewell and Dr. Fischer have extensive experience in performing this combination procedure and will determine if this is a safe option for you.

Breast implants do not impair breast health. Careful reviews of scientific research by independent groups such as the Institute of Medicine have found no link between breast implants and autoimmune or other systemic diseases.

Yes, your breast implants can be removed if you no longer want them in your body. Complete removal of the breast capsules can be performed with removal of your implants.

Dr. Hewell and Dr. Fischer see all of their breast implant revision patients the day after surgery. The Doctors and their exceptional team will take care of all dressings at this visit.

Dr. Hewell and Dr. Fischer recommend annual physical examination to assess the integrity of the breast implants. The implants are not guaranteed to last a lifetime, and future surgery may be required to replace one, or both of the implants. Over time, your breasts can change due to normal aging, pregnancy, weight fluctuations, and menopause. When breasts change due to the aforementioned factors, some patients choose to undergo a breast lift or implant exchange to restore a more youthful appearance to the breasts.

Yes, you can undergo mammography after breast implant revision surgery. Dr. Hewell and Dr. Fischer recommend annual physical examination with your primary care provider and regular screening mammograms after breast implant revision surgery for breast cancer surveillance. If you have a personal history of breast cancer, you should resume your routine surveillance as outlined by your medical oncologist and breast surgeon.

You should bring your most recent mammogram report to your consultation if you have started screening mammograms. Additionally, you should bring any information about previous breast biopsies if you have had a breast biopsy, or any information about your breast cancer if you have a personal history of breast cancer.

Procedures 3



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