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Breast Revision (Capsular Contracture · Implant Exchange)
Breast revision corrects problems that have arisen after a previous surgery, such as capsular contracture, implant malposition and asymmetry, and begins with examinations to identify the cause.
01
Overview
Breast revision is more difficult than a first surgery. It begins with tissue that has already been dissected, skin that has thinned, a capsule hardened by scarring and a nipple position that has shifted. That is why revision does not start with exchanging the implant, but with finding out why the problem arose. At Atelier Plastic Surgery, we use ultrasound at the consultation to check the condition of the implant, the capsule and the thickness of the tissue, order further imaging when needed, and only then make a plan.
Capsular contracture that keeps returning despite several surgeries, an implant that has shifted downward or to the side, rippling in which the folds of the implant show through thin skin, and late skin laxity in which the skin stretches again years after a combined augmentation and lift often have not one cause but several that overlap. Dr. Go has lectured on late skin laxity in the complication prevention and management session of a breast surgery meeting, and has taught physicians from abroad on the subfascial approach in primary and revision surgery and on managing complications.
What revision needs above all is a plan to finish in one surgery. Based on the examination findings, we decide whether exchanging the implant alone will resolve the problem, whether the capsule needs to be treated and the pocket redesigned, or whether a lift or fat grafting should be added, and we explain that reasoning to you plainly at the consultation. If records of your previous surgery are available we review them together; if not, we start from your current condition as shown by the examinations.
02
Recommended for
Hardening, a change in shape or pain around the implant (capsular contracture)
An implant that has dropped or shifted to the side, leaving the two breasts far apart
Both implants drifting toward the center so that the cleavage between the breasts has disappeared
Differences in size, height or nipple position between the two sides
Folds of the implant showing through or palpable beneath thin skin (rippling)
Skin that has stretched again over time after augmentation mastopexy, with tissue sagging below the implant
Suspected implant rupture or rotation, or wanting an older implant exchanged or removed
A problem that arose after a previous surgery whose cause has not yet been identified
03
Surgery & treatment methods
01
Capsular contracture correction
The capsule surrounding the implant has thickened and contracted, making the breast hard and changing its shape. The capsule is removed or released to regain the space and the implant is exchanged; to reduce recurrence, the plane is changed (between subfascial and submuscular) or a new pocket is created, as decided by the examination findings. Where needed, a reinforcing material such as hADM is used as well.
Suited for · Hardening and a change in shape around the implant, or capsular contracture that has recurred
02
Correction of implant malposition · asymmetry
When an implant has dropped or shifted to the side, or both implants have drifted toward the center, the stretched pocket is reduced with internal sutures and the inframammary fold and the lateral border are fixed again. If the tissue is too weak for sutures alone to hold, it is supported with a reinforcing material. Where the two sides differ, implants of different sizes or shapes, a lift and fat grafting are combined to match them.
Suited for · An implant that has moved out of position, or breasts that differ from side to side
03
Rippling improvement
The subcutaneous tissue is thin, so the folds of the implant show through or can be felt. Autologous fat is grafted into the thin areas to add thickness, the type, surface or fill of the implant is changed or the plane is moved deeper, and where needed the implant is covered with hADM. How rippling can be prevented at the stage of planning a first augmentation is explained in the hybrid (implant + fat grafting) section of the implant breast augmentation page.
Suited for · A slim build with thin subcutaneous tissue, where the folds of the implant show
04
Late skin laxity (late envelope failure) correction
Years after a combined augmentation and lift, the skin has stretched again, the breast tissue has slid below the implant or the nipple has dropped again. The stretched skin is re-excised and the tissue repositioned; the size and weight of the implant are reduced or the plane is changed; and the internal support is reinforced so that the same change does not recur. Dr. Go lectured on this topic in the complication prevention and management session at Seoul Breast Meeting 2026.
Suited for · Sagging that has returned over time after augmentation mastopexy
05
Implant exchange · removal
When a rupture or rotation, or an older implant, calls for an exchange, the condition is checked with ultrasound and, where needed, MRI before the implant is replaced. If you would prefer to live without implants, a lift or fat grafting is planned together with removal, taking into account the skin laxity and loss of volume that remain afterwards.
Suited for · Confirmed implant rupture or rotation, or wanting the implants removed
04
Illustrations & photos
Before · Revision design · Right after revisionBefore · Revision design · Right after revisionBefore · 28 days after revision
Surgical designs and results are drawings based on photos; results vary by individual.
05
Key facts
Surgery time
About 2–4 hours (varies with the extent of correction)
Anesthesia
General anesthesia (with an anesthesiologist)
Hospital stay
Same-day discharge or 1 night
Stitch removal
About 10–14 days
Return to daily life
About 1–2 weeks
Follow-up visits
After surgery: 1 week · 2 weeks · 1 month · 3 months · 6 months, then regular ultrasound checks
These may vary depending on your condition; we will give you precise details at your consultation.
06
Atelier Plastic Surgery's approach
01
Examination comes first
The cause cannot be known from the outward shape alone. Ultrasound is used to check the condition of the implant, the thickness and position of the capsule and the thickness of the tissue, and an MRI is ordered if rupture is suspected. If records of your previous surgery are available, the type of implant and the plane are checked as well.
02
We assume there is more than one cause
What looks like sagging may in fact be an implant that has dropped, and rippling, capsular contracture and asymmetry can all be present in one breast. We separate the problems, find the cause of each, and plan them in an order that allows them to be resolved together in one surgery.
03
The pocket and the plane are redesigned
The result of a revision depends on how the space the implant will sit in is rebuilt. Based on anatomical features such as tissue thickness and the remaining supporting structures, the plane is chosen between subfascial and submuscular, a stretched pocket is reduced and weak areas are reinforced. Dr. Go has lectured to physicians from abroad on the subfascial approach in primary and revision surgery.
04
We keep checking after the revision
Regular ultrasound checks confirm that the corrected problem has not returned. The earlier capsular contracture or a change in position is detected, the easier it is to address.
07
After surgery
Day of surgery
After waking from general anesthesia, you rest in a private recovery room. Depending on the extent of correction, drains are placed, and you wear a compression bra or band. Depending on your condition, you go home the same day or stay one night.
Days 1–3
There is swelling and stiffness, and recovery may be slower than after a first surgery. Take the prescribed medication and avoid raising your arms high. Drains are removed once the output has decreased.
Week 1
At the first visit we check the wound, the position of the implants and the blood supply to the skin. Seated work and light outings are mostly possible.
Week 2
Stitches are removed and scar care begins. If the pocket was reduced, you continue wearing the band and support bra so that the implant settles into place.
Months 1–3
Swelling subsides and the shape stabilizes. Light exercise can begin; exercise that uses the chest muscles is resumed after a check at your visit. The implants are checked with ultrasound.
6 months and after
The shape is stable and the final result can be judged. Regular ultrasound checks continue afterwards to watch for recurrence.
Recovery care and the aftercare schedule are described in the Safety Care System. Safety Care System
08
Side effects · Precautions
Breast revision carries a higher risk of complications than a first surgery. Possible complications include bleeding and hematoma; infection (the risk is higher in revision surgery); seroma; recurrence of capsular contracture; recurrence of implant malposition; impaired blood supply to the skin, nipple and areola (the risk is higher when the skin is thin or there have been several incisions); changes in sensation; thickening of the scar from re-incising an existing scar; residual asymmetry; rippling that is reduced but still present; sagging and loss of volume after implant removal; and the possibility that further surgery will be needed. Where the skin is thin or tissue is lacking, there are limits to what can be corrected, and results vary with the condition left by the previous surgery and with your individual tissue. Smoking affects wound healing and blood supply, so you must not smoke before or after surgery. At the consultation we explain the risks that apply to you fully, based on the examination findings.
The content on this page is general medical information provided in accordance with the Medical Service Act. The results of surgery and treatments and the recovery period may vary by individual. All surgeries and treatments carry a risk of side effects, so please decide after a thorough consultation with a specialist.
09
Related research
ConferenceSpeaker
Augmentation Mastopexy; Late Envelope Failures — Late skin-envelope laxity after augmentation mastopexy
Seoul Breast Meeting 2026 · Video Session: Complication Prevention & Management in Aesthetic Breast Surgery · 2026.07.12 · Maria Hall, The Catholic University of Korea College of Medicine, Seoul
A lecture in the complications session on preventing and managing the skin laxity that develops over time after augmentation mastopexy
ConferenceSpeaker
The Subfascial Approach — Primary and Revision Cases
Invited lecture for visiting physicians from abroad (Guangzhou, Wuhan, Hefei and Fuzhou, China) · 2025.11.28 · Atelier Plastic Surgery, Seoul
Selecting the approach by anatomical features and managing complications
Each treatment page lists the items relevant to it; the full list is on the Academic Activities page.View all academic activities
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FAQ
Q1How long after the first surgery can a revision be done?
Unless there is an urgent problem such as infection or hematoma, revision is generally planned about 6 months or more after the first surgery, once the tissue has settled, because the shape cannot be judged accurately while swelling remains. Rupture or severe capsular contracture, however, may be treated earlier; the timing is decided after examination.
Q2Can capsular contracture come back after revision?
It can. Removing the capsule, changing the plane and exchanging the implant reduce the risk of recurrence, but this varies with your individual constitution and the condition left by the previous surgery. Regular ultrasound checks after surgery are important for detecting it early.
Q3Can you revise surgery that was done elsewhere?
Yes. Records of the previous surgery (the type and size of the implant and the plane) help with planning, but even without them we assess your current condition with ultrasound and, where needed, MRI before making a plan.
Q4Does revision get rid of rippling?
Rippling is produced by the thickness of the subcutaneous tissue together with the characteristics of the implant, so the goal is to reduce it. Adding thickness with fat grafting and adjusting the type of implant and the plane can be expected to bring improvement in most cases, but where the skin is very thin some rippling may remain.
Q5What will my breasts look like if the implants are simply removed?
Volume is lost equal to the space the implant occupied, and the stretched skin that remains can look saggy. The degree varies with the elasticity of your skin and the size of the implant; where needed, a lift or fat grafting is planned together with removal.
Q6How is an implant rupture detected?
A ruptured silicone implant often shows no outward sign. Ultrasound can detect most ruptures, and an MRI is ordered in unclear cases. Once rupture is confirmed, an exchange is planned.
