BREAST IMPLANT REVISION SURGERY IN BRISBANE Discover your options for breast implant removal or replacement surgery. Scroll down to view benefits, risks and the factors to consider when thinking about this procedure. BOOK A CONSULTATION HERE.Home > Breast implant revisionWhat is breast implant revision surgery?Breast implant revision surgery can include a number of procedures: Ebreast implant removal and replacement - with or without a breast lift (mastopexy) Ebreast implant removal without replacement Ebreast implant removal without replacement and a breast lift (mastopexy)This above featured patient had previously undergone two breast augmentation procedures with other surgeons, the first using round 450cc implants in the 1980s and revision surgery more recently, using anatomical 290cc implants. She wished to increase breast volume while also reducing excess skin that had developed through the normal ageing process. During the patient’s pre operative consultations, Dr Sharp uses anatomical measurements and patient indications to deduce implant size relative to chest width and safety. The pros, cons and risks of a one-stage revision and mastopexy procedure were weighed up against the risk profile of a two-stage procedure, whereby the implants are removed and mastopexy performed initially, and then 6 months later the augmentation is performed. This patient chose to have a one-stage procedure; her implant pocket was revised and a mastopexy performed to lift the breast into a higher position on her chest. Finally, cohesive gel round high profile 450 cc implants were placed. Dr Sharp utilised implant ‘sizers’ intraoperatively. These photos show the patient’s recovery and mastopexy scarring at only 3 month post surgery, still in the early stages of the 24 month scar development process.Make an enquiryHave a question about the procedure?Complete the form below and we will be in touch ASAP.Name*Email* Phone*Message*PhoneThis field is for validation purposes and should be left unchanged. Submit When viewing before and after images, please note they are only indicative of the individual patient’s result and outcomes vary depending on a number of factors including genetics, nutrition, natural body habitus and adherence to post operative instructions. To view scarring, please click hereThe patient below underwent breast implant revision surgery (removal and replacement) with Dr Sharp. For her original augmentation with another surgeon, the patient had 330 high profile round ‘Brazilian’ polyurethane implants placed above the muscle (sub glandular placement). She saw Dr Sharp because she was satisfied with the appearance of her breasts, but had a grade 4 capsular contracture. During the patient’s pre operative consultations, Dr Sharp discussed the process of capsule removal, implant size and profile choices and revising her implant pocket, changing it from above the muscle, to a dual plane. During the operation Dr Sharp utilised implant ‘sizers’ to ascertain the correct size and profile to achieve a similar look and size to the patient’s previous augmentation. Cohesive gel 455 cc round, ultra high profile implants were used. These implants have a better safety profile than the highly textured implants she previously had, but they still carry risks of capsular contracture and rupture, as do all implants. Read on for more information about the risks and recovery involved in this procedure.What does a breast implant capsule look like?In this video, Dr Sharp shows a breast implant contained within a capsule. If you cannot view the video, please log into your YouTube account to verify your age. Dr Sharp frequently removes and replaces breast implants for women who wish to upgrade their prosthesis or obtain a change in breast shape or size. In most cases, Dr Sharp aims to remove the capsule along with the implant (called a ‘capsulectomy’). Complete removal of the capsule cannot be guaranteed as it can be adhered to the chest wall or adjacent tissues. Capsules form around implants naturally, and usually don’t pose significant risk of complications if a smooth, micro or nano textured implant is used. But for some patients, they can lead to discomfort and changes to breast appearance. Proudly contributing to the BREAST IMPLANT REVISION GALLERY: BEFORE + AFTER PHOTOScroll down to read more about breast implant revision surgery with Dr Sharp, after the image gallery. before and three months after breast implant removal and replacement surgery with Dr Sharp before and three months after removal and replacement surgery with Dr Sharp before and three months after removal, replacement and mastopexy (lift) surgery with Dr Sharp. Note scarring is shown in the early stages of the 24-month maturation process. above: before and five months after removal of implants and one session of fat grafting. before and three months after implant removal and mastopexy (lift) surgery with Dr Sharp before and four months after implant removal and lift surgery with Dr Sharp. Note scars are in the early stages of the 24 month maturation process. before and five months after removal of ruptured 350cc implants, lift and replacement with new cohesive gel 350cc round implants before and five months after removal of ruptured implants and breast reduction with Dr Sharp above: before and five months after breast implant removal and lift surgery with Dr Sharp before and three months after implant removal and replacement surgery with Dr Sharp before and three months after implant removal and replacement surgery with Dr Sharp before and after implant removal and replacement surgery with Dr Sharp before and three months after implant removal and replacement surgery with Dr Sharp before and four months after implant removal, lift (mastopexy) and replacement surgery with Dr Sharp. Note scars are shown in the early stages of the 24 month maturation process.I want to replace my breast implantsWhether an implant rupture or capsular contracture requires you to have your current implants removed and replaced – or you wish to change the size or shape of your breast implants – this procedure involves the removal of your current implants, with or without the surrounding capsule, and replacement with new implants. In some cases an MBS item number applies to this procedure and you may receive a rebate from Medicare and/or your private health fund for some of your surgery costs. Some implant manufacturers have a replacement warranty for capsular contracture or rupture, and may provide new implants at no cost. If you are downsizing your implants, your surgeon can advise whether or not you may benefit from having a mastopexy to remove excess skin and lift your breasts.I want to remove my breast implantsBreast implant removal without replacement is sometimes sought by women who no longer wish to have implants, due to recurring complications, back problems or health issues. In most cases there will be resulting excess skin or possibly asymmetry due to pre existing breast anomalies, ageing and the stretching effect of the implants. You may wish to have the resultant excess skin removed and the breast lifted after the implants are removed, in a procedure called a mastopexy – at the time of removal, or sometime in the future. The surgery can be performed with or without removal of the capsule that forms around the implant, and the risks and benefits of this will be discussed during your pre operative consultations. Sometimes, full capsular removal is not possible due to the capsule’s close proximity to the skin or chest wall.Would you like to know more about Implant Revision? Contact our friendly patient support team.CONTACT USFREQUENTLY ASKED QUESTIONS ABOUTBREAST IMPLANT REVISION SURGERYI WANT MY BREAST IMPLANTS REMOVED or REPLACED…Will my breasts look the same after my revision surgery?In most cases, your breasts will look different after your revision surgery. If you are replacing your implants, they make look higher initially, and you may notice that your inframmary fold (the fold under your breast) is a different height.If you have changed implant shape, profile or size, this will also leave you with a different shape and profile.It’s important to let your surgeon know what you do or don’t like about your current breast appearance so they can factor this into their surgical approach, and discuss your expected result. [Pictured: implant removal, replacement and lift (mastopexy) surgery as a combined procedure shown 3 months after surgery with Dr Sharp].What’s involved in having smaller breast implants placed?Your procedure will depend on the size of your original implants, how much your skin has stretched, nipple position once the implants are removed, the internal chest anatomy that has supported the implants and your inframammary fold.It will also depend upon your desired result and the size of implant you are reducing to. In most cases where a patient is reducing from a large implant down to a small to medium size, there will be excess skin and laxity that requires a breast lift (or mastopexy) if you wish for more projected upper breast pole or cleavage.This is a more complex procedure that involves more scars and carries risks of additional complications – especially when an implant is placed simultaneous to the lift being performed. Your surgeon will discuss the risks and benefits of this procedure with you.Sometimes, this transition is done in a single procedure, or staged over two operations, depending on the patient. Most removal and replacement procedures attract a rebate from Medicare (and if you have appropriate insurance, your private health fund) to cover a portion of the costs.If your inframammary fold requires additional support, your surgeon may recommend the placement of a dermal matrix that acts as an internal ‘sling’ at the base of your breast, to provide additional support for your new implant.I’d like larger implants placed - what’s involved?The first thing Dr Sharp will do is examine your current size and shape, and take measurements of your chest.The gold standard in breast augmentation is to create a balanced appearance and there is a standardised safe ‘range’ for each patient’s breast width, that sets out best practice implant sizing.You will have at least two consultations with Dr Sharp to discuss the procedure and decide upon your ideal sized implants. The surgery itself takes about 90 minutes and involves the removal of the existing implants, any adjustments that need to be made to your implant pocket and inframammary fold and placement of new implants.The procedure may attract a rebate from Medicare (and if you have appropriate insurance, your private health fund) to cover a portion of the costs.If your procedure is deemed cosmetic, a rebate will not apply. Placing implants that significantly exceed the recommended range for your anatomical measurement can not only unnaturally distort your body shape – it can also increase your chances of complications (see complications discussed below) and require costly reconstruction down the track.It can also hinder everyday activities and create an unbalanced proportions. These lifestyle and clinical factors are all taken into consideration when choosing the optimal size increase for you.What is the recovery from breast implant removal and replacement like?In most cases it is similar to the recovery from the primary breast augmentation. Some patients report that the recovery is easier because they knew what to expect after experiencing their first surgery – while others who require extensive capsular removal or mastopexy surgery – report a slower recovery and more swelling.Most patients have 1 to 2 weeks off work, depending on the duties they perform and whether they can have assistance with transport to and from work (no driving during this period). The first 6 weeks will be limited to only light activities, lifting nothing more than 1-2kg; being careful not to raise your arms above your head and generally taking care with your upper body movements. You will need to wear a special support bra (which we provide) for at least the first 6 weeks.Swelling can take 3 months to settle, implants can take 12-24 months to settle into position as the internal scars change and supporting structures adjust and soften – and scars take up to 2 years to ‘mature’ into their final form.If your procedure also requires a mastopexy, your recovery will be more complicated, more painful and slower – as you will have more scarring and breast tissue and skin will have been removed. Read about mastopexy recovery here. I have a double bubble breast implant deformity - can this be corrected?Yes. A ‘double bubble’ (example pictured above for education purposes) occurs when implants are placed behind the chest muscle and the natural breast what is double bubble breast implant tissue sits below the implant.The causes of this can be multifactorial, and can include the placement of natural breast tissue, the placement or position of the implant (or migration after surgery).Sometimes, it occurs when a patient accidentally over-exterts the chest muscles after surgery, which is why it’s very important to be patient and take care when lifting or pulling heavy objects at any stage after augmentation surgery, as your chest muscle anatomy is impacted by surgery and the fact you have implants changing your natural dynamics.Another double bubble scenario occurs when your preoperative natural fold (inframammary crease) is too high. As a result, there is a visible groove between your nipple and the new lower crease.Placing breast implants behind the muscle does not mean a woman will develop double bubble and it is not always the results of surgical error.Improving a ‘double bubble’ can require further surgery, or leaving the breast as it is. Further surgery will incur cost and additional recovery.My breast implants have bottomed out - can you improve this?Yes. ‘Bottoming out’ occurs when a breast implant slips below the inframammary crease (the fold under your breasts).The fold becomes lower, and less defined, and the nipple and areola may tilt upward as the breast implant sits lower than where your surgeon originally placed it. The scar from your original breast augmentation may also sit higher up on the breast over time.Bottoming out can occur if your implant is too big and heavy for the amount of skin and underlying breast tissue – or if, postoperatively, it did not receive adequate support. This can occur when a supportive bra is not worn consistently, or is poorly fitted to provide the inframmary support – especially while exercising.In some cases, patients may feel they have ‘bottomed out’ implants, but upon examination it is found that they have had an increase in breast tissue or fat in the lower pole of their breasts in the years after surgery. Breasts can continue to enlarge as we age, and weight gain will also affect results in this manner. There are several options based on how extensive the implant bottoming out has been. Your surgeon can sew the capsule under the breast in order to push the implant higher in the pocket and center the nipple and areola on the breast mound. This can be done using sutures or via a flap of tissue from the inside of the implant pocket, however if oversized implants are the cause of your bottoming out, you may continue to have recurrent complications and a smaller implant should be placed. In some cases, a breast lift (mastopexy) could also be required. Further surgery incurs costs and additional recovery period.If I have implants removed and not replaced, will my breasts look the same as they did before?No, they will look different. After explant surgery, breasts rarely return back to what they looked like before you had breast implants.You will need to consider the fact that your skin has been stretched by the size and weight of your implants, and also with time and ageing, your natural breast tissue and skin condition will be different now.Sometimes, women are disappointed with the appearance of their breasts after having explant surgery due to excess skin and stretching of the breast, and opt to have further surgery to lift their breasts, or have fat transferred to their breasts to restore volume. This incurs further costs and a recovery period.Dr Sharp will discuss these options with you at your pre operative consultations, and the decision to proceed with further surgery to correct any asymmetry or breast changes can be delayed until months or years after your removal surgery, so there is no rush to make a final decision about this at the time of your implant removal.Do I need to have a breast lift (mastopexy) after explant surgery?Dr Sharp offers mastopexy surgery for excess skin or breast ptosis after breast implant removal; in our clinic’s experience, most patients choose to do this for cosmetic reasons, however it is not medically required in most cases – and is entirely your own decision.We respect that the scars, additional surgical costs and the more extensive surgery involved with this may not be for everyone; we will always respect your choice as to whether or not you wish to have a mastopexy after your breast implants are removed, and Dr Sharp will discuss the benefits and risks of the mastopexy procedure with you at your pre operative consultations.My breast implants are ruptured; do I need emergency surgery?In most cases, a ‘contained’ rupture is not considered an emergency. If you have modern form stable cohesive gel implants, the silicone itself will stay contained within the outer shell of the implant.Sometimes ruptured implants will cause discomfort and swelling, and so for this reason Dr Sharp always tries to see any patients with rupture concerns as soon as possible, so a plan of action can be put in place. If this applies to you, please let our bookings team know at the time of scheduling your appointment so you can be placed on our priority waiting list for the earliest possible appointment. and obtain a GP referral and ultrasound prior to your consultation with Dr Sharp, so a surgical plan can be promptly developed, if applicable.Sometimes it is very evident when an implant ruptures, but other times it can take months or years to be detected – and even then, ultrasounds can indicate a possible rupture, and when the implant is removed, no rupture can be found. An MRI provides more conclusive imaging of implants than an ultrasound, but even then, may not definitively indicate whether or not a rupture has occurred.An ‘unconfined’ rupture occurs when the outer shell of the implant has rupture and silicone sits in tissues or lymph nodes near the implant.Finding out that your implant might be ruptured can be a scary experience and its understandable to feel anxious, but usually the surgery to correct his is straightforward and involves removing the implant, cleaning the breast pocket and replacing it with a new implant.Most breast implant manufacturers in Australia offer a replacement warranty for implants if they rupture, so in some cases your implant will be provided by the manufacturer at no cost, and there will also be a rebate from Medicare (and if you are insured, your health fund) to cover some of the costs of the procedure itself. These are important risks to discuss with your surgeon preoperatively.Risks of surgeryPossible complications of surgery include:Acute medical event such as stoke, heart attack, pneumoniaThe need for revision or further surgery Pain which does not respond to pain relief Nerve damage, causing altered sensation or loss of sensation – temporary or permanentHaematoma (collection of blood), oedema (collection of fluid) and abscess Deep vein thrombosis (DVT) or pulmonary embolisms (PE)Damage or or loss of loose teeth during placement of anaesthetic apparatusSore throat, swelling or discomfort following placement of breathing tubes during anaesthetic Breathing difficulties following anaestheticAllergic reaction to medication Allergic reaction to sutures, dressings, tapes or intraoperative solutionsHeavy bleeding from the wound, which may require further surgeryPoor or slow skin healing, wound infection, breakdown or necrosis (skin death)Wound dehiscence (incision separation)Adverse scarringPsychological impact of surgery, recovery or altered appearanceImplant infectionCapsular contracture Implant rupture Implant migration or rotationRippling – especially common for women with very little breast tissue covering the implant Symmastia (no separation between breast) BIA-ALCL or breast implant illness – click on the links to read dedicated articles about these topicsDeathHow can I avoid breast augmentation complications that require revision surgery?This is one of the greatest concerns we hear from women when having their initial implant surgery – and if you are asking yourself the same question, it’s a good sign that you are consciously weighing up the risks and benefits of surgery from an informed perspective!All surgery carries risks, and while it’s easy to get caught up in the excitement of planning a breast augmentation, it’s also vital to understand that complications occur sometimes, and if you intend on having breast implants for the next 40 years of your life, it is likely that they will need to be revised during this time. There will be surgical costs, and recovery time, involved with this.The most common breast augmentation complications are capsular contracture and rupture; it’s not possible to 100% prevent these, however some steps can be taken to reduce these risks, such as choosing certain implants and ensuring the sterility of the environment in which they are placed – that’s why Dr Sharp only performs this surgery in accredited hospitals under general anaesthetic, and opts for high quality form stable cohesive gel implants.While the implants available in Australia undergo stringent testing before being made available here – and are very durable – sometimes ruptures inexplicably occur, even if the patient hasn’t had a trauma or accident in the chest area, which would easily explain the rupture. As Dr Sharp uses specific implants with a good safety record, if you do have a rupture, the silicone usually stays contained within the outer shell.Other complications, such as seroma, haematoma and infection, are uncommon but can be addressed promptly and effectively if you notify your surgeon as soon as you have any concerns.Breastfeeding and pregnancy will always change your breasts, and are another reason patients seek out revision surgery, so if this is a concern for you if might be worthwhile considering delaying your augmentation until after you have finished having your family.Other complications – such as a ‘double bubble’ or ‘bottoming out’ discussed above – can be minimised by choosing an implant that is appropriate for your body, taking great care during your post operative recovery period and choosing an experienced plastic surgeon. We are frequently contacted by people who have had very large implants placed elsewhere, only to find their bodies can’t support the size, and they cannot afford the expense of corrective surgery privately, especially if they’ve had cut-price surgery overseas. Overly large implants can cause many problems and this is one of the reasons why Dr Sharp aims for sensibly sized implants suitable to the patients’ chest measurements. lifestyle and body habits.Taking care with your recovery and observing your post operative instructions is also integral to preventing complications. After the initial recovery period, your implants will eventually feel very much a part of your body, and you will carry out your every day activities not really thinking too much about them! While this is very normal, it’s important to remember that you’ve had surgery in this area and your body is supporting a foreign object – so you will always have to consider your breast implants during heavy exercise or when performing rigorous activities that involve your chest muscles.And finally, it’s important to monitor your breasts – and if you notice any changes, irregularities, swelling or discomfort to see your GP. In most cases, if you have breast implants and your GP has any concerns, they will refer you to have an ultrasound – and if any problems with your implants are found, its important to make a prompt appointment with your plastic surgeon.Does Dr Sharp perform en bloc capsulectomies?Patients sometimes report reading on forums that an ‘en bloc resection’ is vital, if they think that they have ‘breast implant related illness’ (BII). ‘En bloc’ has become a popular term, and is often incorrectly interpreted.Currently there is not enough scientific evidence to suggest that a radical en bloc resection is necessary when removing an implant. En bloc capsulectomy often involves removing the capsule off of the chest wall and ribs, which may require a much larger incision – and up to triple the length of time under general anaesthetic, as the procedure is performed in a slow and meticulous manner. Not all capsules are the same. Frequently, if the capsule is thin, the space will collapse after the implant is removed, making complete capsule removal more dangerous to attempt versus just removing the majority of the capsule and leaving the adherent portion in place.When deciding whether or not to perform one, a surgeon must also weigh up the additional complications it can cause. Many surgeons prefer to perform an anterior capsulectomy with the implant and leave the base of the capsule intact to avoid potential complications of posterior capsulectomy (eg pneumothorax, chest wall injury) especially if the patient has very thin chest wall musculature. In most cases, the removal of implants with a standard capsulectomy is sufficient to see an improvement in BII symptoms.It is frequently not possible or very difficult to remove the entire capsule without removing the implant first. In this case, the capsule is dissected away from the surrounding tissue as much as possible and the capsule is opened allowing removal of the implant, or implant material if the implant is ruptured, followed by removal of the remaining capsule as indicated.If there is a capsular contracture present, most surgeons will remove a portion or all of the capsule. Simple implant removal and capsulectomy (partial or complete) is also usually adequate in most BII cases. If there the capsule is abnormal, it is sent to be evaluated by a pathologist.This is why Dr Sharp emphasises to all explant patients that en bloc capsulectomy may not be possible due to a number of factors that often only become apparent during surgery. While forums are undoubtedly a valuable resource, always discuss your options with a specialist plastic surgeon to ensure your surgical plan meets your own specific medical needs.How can I improve breast revision scarring?All surgery involves permanent scarring that will always be visible, but much can be done to optimise scars. The best way to do this, is to follow postoperative instructions carefully.The scar maturation process takes the scar approximately 24 months in total, so patience is needed in order to see the final result! While it might be annoying to hear ‘be patient’ during this period, it is important to give your body time to fully heal.Rest assured that if postoperative instructions are closely followed, patients usually find their breast scars mature into soft, lightly-coloured scars that are not anywhere near as prominent as they appear to be in the first 3-12 months.Keep in mind that repeated surgery in the same area can result in more prominent scarring, or internal scarring that causes firmness, indentations or puckering. Daily, at-home incision massage (using approved products) and the assistance of a qualified therapist can be effective in reducing this.