Theres’s no single right time for breast augmentation revision. Sometimes it is necessary to treat a complication like bleeding or capsular contracture, or maybe it is just time to upgrade to a newer type of implant or to change sizes. But whenever a revision is planned, it can feel overwhelming. However apprehensive you feel, there is nothing to be afraid of. As I reassure my breast augmentation revision patients in Columbus, Ohio, the surgery is a natural part of the breast augmentation life cycle, and there can be real advantages to updating your implants.
When Should You Upgrade Your Breast Implants?
If your original implants are more than 10 years old, technology has likely passed them by. Over the last 15 years, implant design has gone from fine to fabulous. Today’s fifth-generation implants, sometimes called highly cohesive, “gummy bear,” or form-stable implants, hold their shape even if the outer shell is compromised, rather than rupturing into loose, sticky gel. This is why I use only this newer generation for my breast augmentation patients today.
If your first implants were saline, upgrading now means skipping straight past 15 years of intervening technology to the very best implants currently available.
Breast Revision for Body Changes: Weight, Pregnancy and Time
A lot can happen to your body in a decade. Weight gain or loss, pregnancy (sometimes multiple), breastfeeding, and general time can all change how your implants sit and look. Some patients have saline implants that are still fully intact with no significant body changes—these are usually the simplest revisions. Others have experienced enough change that the implant capsule itself needs to be addressed, not just the implant swapped out.
It’s also common for a saline implant to slowly deflate without a patient realizing it, especially if weight gain has masked the size difference, often on just one side. Wondering what breast augmentation revision results look like? Take a look at my patients’ before and after pictures in our photo gallery.
Revision for Size or Symmetry Changes
One of the most common reasons for revision has nothing to do with a problem at all; it’s simply wanting a different size. Patients whose bodies have changed due to weight fluctuation or pregnancy, or who are just ready for a different look, can update their implant size. A noticeably larger or smaller result generally requires at least a 100cc change; a subtle increase is closer to 50cc. This type of revision can often be done in-office with twilight anesthesia. Many patients have the procedure on a Thursday and can return to work on Monday.
Saline vs. Silicone Gel Implant Revision: What to Expect
The right revision approach depends partly on which type of implant you currently have.
Saline Implant Revision:
If you have saline implants with no issues, this is typically the most straightforward revision. You can simply swap to today’s newer gel implant technology. But if you’re dealing with body contour changes from weight gain or multiple pregnancies, or your implants feel firmer or sit higher than they used to, you’ll need a more involved solution that addresses the capsule itself, not just the implant.
Silicone Gel Revision:
Patients with silicone gel implants and no complications can also upgrade to newer implant technology with a simple swap, provided the capsule is soft and the breast still feels natural. But if the capsule has tightened into capsular contracture, more involved surgery is needed.
What Is Capsular Contracture, and Does It Require Revision?
Capsular contracture happens when the scar tissue capsule around an implant tightens significantly, making the breast feel firm or look distorted. It’s one of the more complex revisions to address, since part or all of the capsule may need to be removed. In some cases, removing the implants and performing a breast lift is a better option than replacing them.
Do Thicker Implant Capsules Need to Be Removed?
Not every capsule issue is true capsular contracture. Over time, some patients develop a capsule that’s simply thicker or tighter than ideal—limiting how soft and natural the implant feels—without meeting the criteria for contracture. In these cases, a complete or partial capsule removal at the time of revision can restore a softer, more natural result.
This is a larger operation requiring general anesthesia, often with drains left in place for up to a week. Sometimes the implant is also repositioned to a new pocket. Every case is different—your board-certified plastic surgeon will walk you through exactly what your revision involves during your consultation.
What is Animation Deformity?
There is a rare but real condition where the implants that are placed beneath the muscle can shift or distort with pectoral muscle movement. If animation deformity is bothering you, the implants that are placed behind the muscle can be switched and placed on top of the muscle, if there is enough subcutaneous fat on the chest wall. For patients who do competitive bodybuilding, putting the implants on top can be the best answer, and it really is a compromise of the animation and the visibility of the implant. During competition, when the patient is at her leanest with a low body fat composition, the implant ripples can be more readily seen, but there would not be any animation deformity.
What Does Correcting the Implant Over Time Involve?
When gravity affects implants over time, we can tighten the capsule to properly position the implant. Even for a very good long-term result, there are minor tuneups that can be done to the capsule at the time of the revision. We have all seen ladies lying out in the sun at the pool or beach who have implants that are too far over to the side of the body, and the gully between the breasts along the sternum is very wide. This is because even in the best case, over a long period of time, gravity pulls the implant over this way, and the pocket gets looser or more stretched out along the side.
Tightening the capsule along the outer pole of the breast prevents the implants from shifting to the side of the body, especially when lying down. This type of “down and out” migration of the implants is more common for saline or larger silicone implants. As we all know, gravity is our enemy!
What If You Don’t Have Previous Implant Records?
While missing records from your prior breast augmentation surgery aren’t a dealbreaker, they’re helpful to reference when planning for revision surgery. Ideally, you should have received an implant record card and tucked it away safely so you can find it now! The style and size of the implants helps direct the next operation. If you want to be the same size, smaller, or larger, it’s a snap when you know the original size. But if you do not have the records, it just means that multiple sizes will be considered—what we call “the tower of tits.” In the OR, when the old implants are removed and the actual size noted, the decision is made then.
Why Is It important to Choose an Experienced Revision Specialist?
Revision surgery requires a different skill set than a primary augmentation—look for a board-certified plastic surgeon experienced in both. Whether you’re a returning patient or new to our practice, I’ll leverage my 23+ years of experience to guide you toward the right path forward based on your goals and implant history.
To learn more about your breast implant revision options at our Columbus plastic surgery practice, use our online form to request a consultation. Or call us at (614) 569-2649 to schedule an appointment.
Breast Wishes.
This blog post was originally published in April 2022 and updated in July 2026.
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