About the procedure
Hardening around the implant (capsular contracture), a change in the desired size or displacement of the implant may call for revision. During surgery, the old implant and, if necessary, the capsule are removed and a new implant is placed.
If sagging has developed over time, a lift is added in the same session. For patients who no longer want implants, removal with fat transfer is considered.
Revision planning differs from the first surgery: the type of the existing implant, its placement plane, the condition of the capsule, and the changes in the skin over the years are assessed separately. If the capsule has hardened, replacing the implant alone is not enough; partial or complete removal of the capsule (capsulectomy) and, if needed, a change of placement plane are planned. In patients who want removal only, the shape is preserved with a lift or fat transfer depending on the remaining tissue; the decision is guided by preoperative imaging and examination.
- ✓Access through the existing scar
- ✓Combined with a lift
- ✓Current-generation implants
Suitability
Who is it suitable for?
May be suitable
- ✓Patients experiencing hardening, distortion, or pain around the implant.
- ✓Those in whom imaging has shown implant rupture or gel leakage.
- ✓Those dissatisfied with their implant size who want to go larger or smaller.
- ✓Patients whose implant has shifted, dropped, or whose breasts have moved closer together.
- ✓Those who want to correct sagging that has developed over the years along with an implant exchange.
Should be postponed or is not suitable
- —Implants that cause no symptoms, have normal imaging, and satisfy the patient are not replaced simply because years have passed.
- —If there is an active infection or an unhealed wound along the incision line, it is treated first.
- —If there is unexplained fluid or a mass around the implant, diagnostic workup is completed before surgery.
- —In those who are pregnant or breastfeeding, revision is postponed until the tissue settles.
The final decision on suitability is made after a physician examination and tests.
Process
How does it proceed, step by step?
- 01
Initial consultation
Details of the previous surgery, complaints, and photographs are assessed; you are asked to share your implant card if you have one.
- 02
Imaging and planning
In Istanbul, an ultrasound or MRI is done along with the examination; the condition of the capsule, any rupture, and the implant position are clarified. The new size and, if needed, a lift incision are planned.
- 03
Procedure day
Under general anesthesia, the old incision is used; the implant and, if needed, the capsule are removed, the pocket is adjusted, and the new implant is placed. You stay one night in the hospital.
- 04
First check-up
The next day the drain and dressing are checked; if a capsulectomy was performed, the drain may stay for a few days.
- 05
Pre-departure check-up
The position of the new implant and symmetry are assessed; the capsule pathology result is shared, and bra use and movement limits are explained.
- 06
Remote follow-up
Through the first year, you are monitored with photographs and, if needed, ultrasound to confirm that capsular hardening has not recurred.
Recovery
Recovery timeline
Day 1
If the capsule was removed, somewhat more pain and drain monitoring are expected compared with the first surgery; it is controlled with medication.
Days 3–5
Swelling is noticeable; if the plane was changed, there may be a pulling sensation with arm movements. Short walks are taken.
Week 1
You can return to light work. The sports bra is worn continuously, and no weights are lifted.
Month 1
Most of the swelling subsides and the new implant begins to settle. Light cardio is allowed.
Month 3
Softness and shape become defined; if a lift was added, the scars are still red. You return to a full exercise program.
Year 1
The result takes its lasting form; regular annual ultrasound follow-up is restarted for the new implant.
Timeframes are averages; they vary by person and by the scope of the procedure.
Results
Before / After
Before and after examples of Implant Revision are shared during the consultation.
We show our patients' photos only within the scope of their written consent and in one-on-one consultations; we respect the wishes of patients who prefer not to be published on the open internet. Let us send you results from cases similar to yours together with the physician's assessment.
Let us be open
Risks and points to consider
Every medical procedure carries risks. The points below are the main known issues for this procedure; a risk assessment specific to you is made during the consultation.
- Recurrence of capsular contracture around the new implant; in patients who have had hardening before, the risk is higher than with the first surgery.
- Bleeding from the chest wall and muscles during capsulectomy; if the capsule is thick and calcified, the operation takes longer.
- Displacement, asymmetry, or the need to narrow the pocket again because the new implant does not fit the old pocket precisely.
- Changes in sensation in re-operated tissue, and scar quality that differs from the first surgery.
- In patients whose implant is removed without replacement, a greater than expected loss of breast volume and shape; an additional lift may become necessary.