Breast Implant Revision Surgery

Breast Implant Revision in Orlando, Florida

Have you had previous breast augmentation surgery and want to improve your result, because of size issues, tissue stretch, implant hardening, or implant rupture? Revision implant surgery can be complex.  Dr. Fiala has a great deal of training and experience with breast implant revisionary surgery, especially in the correction of hardened subglandular implants, pocket expansion and implant downsizing.

Common reasons for breast implant revisions

  • Size change: whether it’s changing the implant size or changing the implant shape, size change is the most frequent secondary surgery for breast implants.  Implant downsizing may also require closing the internal pocket or tightening stretched out skin, if the size change is significant.
  • Fixing implant hardness: Also known as capsular contracture, this hardening process of tissue around the implant can cause the breast to become more spherical in shape, more elevated, or more painful. It can be fixed, and the breast shape is made more symmetrical, more natural-looking, and more comfortable.  This may involve capsule removal, changing the implant position, or the use of a capsule-fighting material known as ADM (acellular dermal matrix).
  • Implant Deflation or Rupture: All breast implants eventually wear out with time, and will need to be replaced. With a saline implant, a leak in the implant results in an obvious deflation. With a silicone gel implant, it may be more difficult to tell.  An imaging test, like an ultrasound or MRI of the breast, may be needed to confirm whether or not a leak is present.  Dr. Fiala has an in-office ultrasound machine so we can check for rupture at the time of your consultation.
  • Implant pocket issues: Are the implants too far apart? Do they go under your armpit area when you lie down? If so, then you may have a pocket problem. By re-opening the pocket where needed in the cleavage area, or by closing the pocket near the armpit  with an internal suture repair, these issues can be fixed.  Sometimes a new implant, of a more proportional width, can help to optimize the cosmetic result.
  • Ripples: Do you have ripples or wrinkles that show on the surface of your breast? If you have an “over-the-muscle” saline implant, these can often be significantly improved or eliminated by switching to a silicone gel implant placed “behind-the-muscle”.  Sometimes, more advanced methods, like fat grafting or ADM placement, may be recommended.
  • The desire for removal:  Some women have changed their minds about having implants, and simply would like them removed.

How does Dr. Fiala figure out what my new implant size should be?

For women that wish to go to a larger size, we can place an air-filled sizer over the current breast, and the patient can preview the shape and size in a sports bra & T-shirt. By knowing or estimating the size of the current implant, we can then determine the volume of the new implant by adding the volume of the implant and the sizer together and picking an implant shape that will fit the patient’s frame. Often changing to a higher profile implant may give the fuller and curvier shape desired, without making the breast too wide.

If you have your current implant information, please bring it with you to the consultation.

For women that wish to “downsize”, several options are available. For women that currently have a saline implant, sometimes a pre-operative deflation of the saline implant can be very helpful. This way you can “try on” the new implant just like a first-time patient – and get the size selection “exactly right” prior to the second surgery. For women with silicone implants, a series of measurements and calculations can be done to figure out a proportional implant diameter.

It is quite common to see that the initial implant was overly wide for the patient’s frame.  This can look bulky or matronly in clothes.  Switching to an implant that matches that patient’s frame size can help often looks slimmer and gives better proportions.


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