Breast Implant Replacement


There are two main reasons a women may require breast implant surgery.  The first could be the body’s reaction to the implant (capsular contracture).  The second could be an issue with the implant itself.

Breast implants are not infallible, and as such, are prone to failure at some point in the future. It’s just a matter of when. Typically, if you are happy with your breasts, then you do not need to change your implants unless you are having a problem. The following are common reasons for undergoing breast implant replacement surgery.

  1. Deflation of a saline implant: If you have a saline implant, then any leak, whether in the silicone shell (the bag itself) or in the valve used to fill the implant, will result in a gradual deflation which will probably take about two days to occur. You will then notice a marked difference in the size of your breasts. No further diagnostic testing is required; you simply need to remove the implant. Your options are:
    1. Replace ruptured implant it with a similar implant
    1. Replace both implants with similar implants (especially if it’s been several years since the initial surgery)
    1. Replace the implants with saline implants of a different size 
    1. Replace both implants with silicone gel implants for a more natural feel to the breasts.
  • Rupture of a silicone gel implant: Rupture of a silicone gel implant is a bit harder to diagnose. With newer implants, a small hole in the implant will most likely not leak any silicone gel due to the cohesive properties of recent technology. If there is a tear in the implant shell, then the silicone will be contained by the natural scar tissue capsule that forms around all foreign objects introduced into the human body—and silicone won’t react negatively with our bodies. Because the silicone is not absorbed by our bodies (nor does it travel), the breast will most likely look and feel the same, even though the implant is compromised in some fashion. Due to this, the FDA recommends getting breast MRI’s at three years after surgery and every two years thereafter. Although this is the recommendation, most women do not do this due to expense and rely on clinical exam to monitor their implants.
  • Capsule contracture: Once this occurs, the breast feels hard and may even be uncomfortable. The implant itself hasn’t changed, rather, the scar tissue that forms around the implant thickens and contracts, causing the implant to feel firmer. Treatment involves removing the scar tissue causing the problem and replacing with a fresh implant of the same type and size.
  • Asymmetry / breast deformity: If there is a shape issue that’s concerning, and Dr. Breister Ghosh believes that she can correct this surgically, then it may be reasonable to proceed. This can include issues relating to the original implant surgery, such as improper pocket creation, improper implant selection, issues due to weight loss or pregnancy/breastfeeding, improper positioning of the implant, improper placement, rippling/wrinkling or visibility of the implant, ptosis (drooping) of the breast, breast over-stretching or any changes where the breasts now look too large or too small for the patient’s frame.
  • Desire to change implant size: Many women opt to change the size of their breast implants.  Dr. Breister Ghosh is best positioned to help patients make that determination, in order to avoid over stretching of the skin, or drooping of the skin if downsizing.

Capsule contracture and implant deflation/rupture are the most common reasons for breast implant revision surgery. Ptosis (drooping) may require a breast lift, and rippling/wrinkling or visibility of the implant is usually best mitigated by replacement of the implants (if they are saline) with silicone implants.

If you are happy with the way your breasts look and feel, and are having no issues with them, then there is generally no reason to replace or re-operate. 

Dr. Diana Breister Ghosh is board certified by the American Board of Plastic Surgery, the only plastic surgery board recognized by the American Board of Medical Specialties. She is a member of the American Society of Plastic Surgeons, and the San Diego Plastic Surgery Society, and is an expert in plastic, aesthetic and reconstructive surgery.

Her specialized services include breast augmentation (including silicone breast implants), breast lift (mastopexy), tummy tuck (abdominoplasty), brow lift, and face/neck lift. 

Dr. Breister Ghosh is also recognized as an expert in state-of-the-art surgical body modification, body contouring and soft tissue sculpting following bariatric and major weight loss surgery. Additionally, she excels in performing specialized facial procedures that help restore skin and aid in reducing effects of aging without surgery, including laser facial resurfacing, Botox®, Restylane®, Perlane®, Juvederm™ and Sculptra® and Bellafill®.