Corrective breast surgery overview

Breast implant removal/ exchange

TYPE OF ANAESTHETIC

General

LENGTH OF SURGERY

1-2 Hours

HOSPITAL STAY

0-1

RECOVERY

1-2 weeks off work, 6 weeks before strenuous exercise

Corrective breast surgery

Corrective or secondary breast implant surgery encompasses a wide range of procedures, from relatively simple to highly complex, driven by various factors, including patient desires, complications, and evolving personal health conditions.

Common Reasons for Secondary Breast Implant Surgery:

Upsizing or downsizing: Patients often request larger breast implants as their desires evolve, while others prefer to reduce the size of their breasts.
Capsular contracture: involves the formation of abnormal scar tissue around an implant, which can causes hardening, pain, and changes in breast shape.
Implant visibility: Issues such as feeling or seeing the edges of an implant, visible ripples, folds, or creases.
Implant malposition: Shifts in the implant’s position can lead to aesthetic concerns such as a wide gap, poor cleavage, high-riding implants, or bottoming out.
Tissue changes: Droopiness of native breast tissue can lead to a “double-bubble” appearance, while breast asymmetry may present noticeable differences in size, shape, or position.
Other factors: Unsatisfactory scars, disproportionately large nipples, changes in breast tissue volume, and loss of skin elasticity due to ageing, pregnancy, breastfeeding, weight fluctuations, sun damage, and smoking.

Breast Implant Illness (BII): Breast implant illness refers to a range of symptoms that patients believe are directly linked to their breast implants. Although the exact cause of BII remains unclear, it is suspected to arise from autoimmune or inflammatory reactions to the breast implant materials or surgery or infection related to bacteria on the implant surface. Symptoms are varied and can include joint pain, muscle pain, cognitive issues like anxiety, depression, brain fog, fatigue, memory loss, trouble concentrating, and systemic symptoms such as autoimmune condition symptoms, chronic pain, dry eyes, hair loss, and skin rashes. Diagnosis typically involves ruling out other conditions, and treatment often involves the removal of the breast implants. Studies show that many patients experience an improvement in symptoms shortly after implant removal, although not everyone will see a change.

Complete Breast Implant Removal and Its Impact: The decision to remove breast implants can stem from personal or medical reasons, including dissatisfaction with breast size or shape, capsular contracture, and more rarely, breast implant illness. Breast implant removal surgery, or explant surgery, generally involves removing the implant and possibly the surrounding scar tissue. This procedure can significantly impact the patient’s physical health by alleviating symptoms associated with BII or other implant-related complications. Psychologically, it can also relieve the burden of health concerns attributed to implants. The recovery process and outcomes of explant surgery vary, with many patients experiencing a positive change in symptoms and well-being post-removal. Additional procedures like a breast lift might be considered to address changes in breast appearance after implant removal.

It’s essential for individuals considering or undergoing breast implant surgery to discuss all potential risks, benefits, and alternatives with a qualified healthcare provider to make informed decisions about their body and health.

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Procedure types

Depending on the patient, revision surgery may involve one or a combination of these procedures:

Removal of the old implants and replacement with “like-for-like” or different size, type or shape implant.
Removal of thickened contracted scar tissue lining the implant pocket (capsulectomy).
Change to the existing implant pocket to allow for the insertion of a much larger implant and/ or reduce the gap between the implants (capsulotomy).
Change to the existing implant pocket to correct bottoming out, resulting from a descent of the breast crease and lack of support.
Breast implant pocket switch from above to below the muscle to address rippling and recurrent capsular contracture.
Breast uplift/ reshaping (mastopexy) to correct droopiness.

Commonly asked questions

How do I choose what implant size to go for?

We use a sizing kit to help you decide what implant size is best for you. The sizing kit gives you and us an idea of what you are looking for. It’s useful to bring some of your own tops to see how you look with certain implant sizes. We also have access to 3D imaging which can give you a visual representation of what you might look like with different implants. The type of implants (round/ anatomical or teardrop) and where we place them (above/ below the chest muscle/ dual plane) will be explained to you in full.

What if my breasts are also droopy?

If your breasts have become droopy, then you may be more suited to a breast enlargement combined with breast uplift (Augmentation Mastopexy). This will depend on several factors, such as the position of your nipples relative to your breast crease, what size implant you wish to have and whether you have had previous pregnancies/ weight loss.

If you are unsure about whether you may require an uplift, you can try our cosmetic surgery selector tool.

Will my implants have to be changed after a particular time?

Breast implants need not be replaced after a set period. However, they can cause problems over time and may need to be removed or swapped for technical (implant rupture/ tight scar tissue) or cosmetic (change in breast shape over time/ after pregnancy/ weight loss) reasons. So it is crucial to know that you may require further breast surgery.

Are there any alternatives to breast enlargement surgery with implants?

If you want a modest increase of one cup size, then fat transfer to your breasts may be an option. Fat transfer is a well-established plastic surgery procedure used in breast cancer patients for many years. Fat is removed from your tummy or thighs using liposuction. The fat is then prepared to remove blood and oil and injected into the breasts. Some of the injected fat will be lost over the first few months. The advantage of fat transfer is that you are not putting anything “foreign” or unnatural into your body. The main disadvantage is that only a modest enlargement can be achieved, and the increase in volume is not as reliable as using implants

The advantages of fat transfer breast augmentation

Natural: Only uses your body’s tissues.

No Implants: Avoids implant risks, such as implant rupture and capsular contracture.

Can recontour the body: The liposuction used to harvest fat can reshape the body.
Avoids noticeable scarring: Only tiny incisions are used to harvest and inject fat.

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The disadvantages of fat transfer breast augmentation

Limited enlargement.
Reabsorption of fat: Even in the best hands, the body will resorb some of the transferred fat. There is a chance that a large percentage of the transferred fat will be resorbed, with the result falling below expectations and the need for multiple treatments.
Not effective in correcting droopiness
More expensive. Fat transfer augmentation involves two procedures (liposuction plus breast augmentation) and is usually more expensive than breast augmentation using implants. Additional costs will be incurred should a repeat treatment prove necessary.

Remember:

You may not have enough fat to transfer to your breasts.
You may be happy with your figure and not wish to have it changed.
You may have enough fat for one transfer. What if you need a repeat treatment?

How does recovery compare with that of the first operation?

Women thinking about revision breast surgery will have some idea of what the procedure is like. There are similarities to the original process, but there can also be significant differences depending on the complexity of the revision procedure. A simple exchange of implants for comparable shape/ size can be straightforward as no major work is required on existing implant pockets. But if more complex surgery is needed, the operation will take longer, and the recovery will be more protracted. Examples of complex revisional surgery include correction of capsular contracture, implant malposition and breast uplift.

What to expect

You may be up and about in 2 days, but it will be a few weeks before you are entirely up to speed.

Your mood may fluctuate after surgery – this is normal. A small amount of blood staining on the inside of your dressings is typical during the first few days.

Discomfort/ Pain

Some pain is typical in the first few days after surgery especially if your implants have been placed under the muscle. You may experience some numbness of your nipples and incision areas. You may experience temporary soreness, tightness, swelling and bruising as well as some discomfort in the incision area. Your breasts may be sensitive to stimulation for a few weeks.

Bruising/ swelling

Your breast will feel tight and swollen for several days and bruising is not uncommon.

Appearance

Most of the discolouration and swelling will subside in 4-6 weeks.

Scars may be red and angry looking for 6 months. In time, these usually soften and fade.

Your final breast shape will not become apparent until 6 months.

View before and after gallery

What are the risks?

Revision breast implant surgery is an operation of varying complexity and has a degree of unpredictability. There is no guarantee of a satisfactory outcome; further surgery may sometimes be necessary. All operations carry associated risks, including those of the anaesthetic and infection. All complications and long-term problems that follow the primary breast implant procedure can happen following revisional surgery. See pages on breast augmentation and breast lift.

Revision breast augmentation aftercare

If you have had revision breast implant surgery with us or are considering it – please find some detailed instructions and advice on aftercare following revision breast augmentation.

Explore breast correction aftercare

Body dysmorphia

Body dysmorphic disorder (BDD) is a mental health condition in which someone can’t help thinking about one or more perceived issues or faults in their appearance. Other people may think that their concerns are minor or they may fail to see them at all.

People with BDD, continuously focus on their appearance and body image, repeatedly checking the mirror, grooming or seeking reassurance, sometimes for many hours each day. The perceived flaw likely causes significant distress and impacts on a person’s ability to function in their daily life.

People affected with BDD often seek out cosmetic procedures to try to “fix” their perceived flaw. Afterwards, they may feel temporary satisfaction or a reduction in their symptoms, but often the anxiety returns, or they may move on to focus on other perceived problems related to their appearance.

Some patients may have features of body dysmorphia. Such patients are not likely to be offered surgery.

If you are considering surgery, it is worth trying the self-assessment tool below known as the Cosmetic Procedure Screening Questionnaire (COPS).

The questionnaire was developed by David Veale, Nell Ellison, Tom Werner, Rupa Dodhia, Marc Serfaty and Alex Clarke (2012) Development of a cosmetic procedure screening questionnaire (COPS) for Body Dysmorphic Disorder. Journal of Plastic Reconstructive and Aesthetic Surgery, 65 (4), 530-532.

TAKE THE COPS QUESTIONNAIRE

Corrective Breast Surgery | Breast Implant Removal