Year after year, breast augmentation ranks as one of the most “Worth It” plastic surgery procedures, within our RealSelf community as well as in reports by the American Society for Plastic Surgeons (ASPS). However, another form of breast surgery that rarely gets the same credit for its satisfaction rate is implant revision surgery.
Breast augmentation revisions are more common than one might assume; in fact, the Aesthetic Society reports that about 30% of breast augmentations performed in 2020 were revisions. There are many reasons for booking this procedure, from changing one’s look (upgrading or downsizing) to correcting potential issues caused by a prior augmentation or the implants themselves. It’s easy to feel overwhelmed when considering implant revision surgery though. Going through that whole process all over again—and paying for it a second time—can be stressful. But did you know that implants in revision procedures may be covered, at least partially, by manufacturers’ warranties? While all warranties differ, Sientra offers the most comprehensive 20-year warranty available across all breast implant brands, giving you way more flexibility when it comes to your next breast enhancement procedure.
Regardless of why you’re considering breast implant revision surgery, it’s always valuable to be well informed when planning major changes to your body. Learning as much as you can ahead of your consultation will also help you ask more specific questions—and make sure you have a good connection with your plastic surgeon. Here, with the help of two board-certified plastic surgeons, we break down everything you need to know about the procedure, from warranty coverage to implant sizing to doctor selection.
Why might someone need breast implant revision surgery?
Advancements in plastic surgery have caused the answer to this question to evolve in recent years. Historically, one of the main motives for revision was to change the size, but advancements in 3D imaging and in-office sizing have helped set more accurate patient expectations. Capsular contracture—a condition that occurs when the scar tissue around the implant tightens around the breast, to create an unnatural look—is another common reason for revision surgery, though improvements in surgical techniques to address the condition have lessened the occurrence rate.
In today’s aesthetics landscape, revision surgery is booked for various reasons—including concerns of rupture, due to an aging implant, or implant migration, which occurs when an implant moves away from its ideal location (it can settle too low or shift toward the armpit). Patients also choose to revise their implants when they’re ready for a change or simply don’t like how their original augmentation turned out (asymmetry is a typical complaint here.) Though less common, conditions like late-forming seromas (fluid buildup around an implant) and BIA-ALCL (breast implant–associated anaplastic large-cell lymphoma) may necessitate a breast implant revision.
Will a breast implant warranty cover breast revision surgery?
There are a handful of issues that qualify for warranty coverage, most of which apply across all manufacturers, but not all warranties are created equal—which is why it’s important to read the fine print of your particular warranty. “Sientra offers the best warranty in the business, which reflects the quality of their implants,” says Dr. Ashley Gordon, a board-certified plastic surgeon in Austin, Texas, and Sientra Advisory Board member. “The Sientra Platinum20 Product Replacement & Limited Warranty Program provides the most comprehensive and longest length of coverage, and it also includes the most financial assistance and fewest warranty restrictions in the industry.” (Plus Sientra currently is the highest-rated silicone gel breast implant brand in the U.S. on RealSelf.)
If you have had your implants for more than a decade
If your breast augmentation surgery was in the 1980s or early ’90s, you might be a bit concerned about the integrity of the devices that are in your body—have they aged as well as you? That’s worth a discussion with your surgeon. “Even after 10 years, if the breasts remain soft and are in good position and the patient is still happy with the size, we should leave them alone,” opines Dr. Gordon, who recommends surveilling implants for potential issues with high-resolution ultrasound, which is more affordable than an MRI. “Trained plastic surgeons can perform this quick ultrasound study in their office in less than 10 minutes and determine whether a silicone gel implant has a silent rupture,” she says.
In the event of an implant rupture
Though the date of your initial breast augmentation plays a role in coverage, all FDA-approved implant manufacturers offer a lifetime guarantee in cases where device failure leads to implant rupture; they’ll replace your ruptured implant (as well as your other implant, even if it’s unaffected). Sientra is the only one of the four implant brands that will provide up to $5,000 in financial assistance for any costs you might incur related to your implant rupture for up to 20 years post-procedure.
If you experience capsular contracture or late-forming seroma
If you have a more mild form of capsular contracture, revision won’t be covered by any of the implant manufacturers’ warranties. For what it’s worth though, it’s only the most advanced forms of capsular contracture that tend to be noticeable—to patients, surgeons, or others—and those are covered by all manufacturers. Sientra’s coverage includes free implant replacement for those complications in the first 20 years, notes Dr. Gordon, as well as up to $2,000 to help defray uncovered fees and costs due to advanced capsular contracture for two years. “This covers all primary and revision augmentation cases,” she adds.
And while most warranties cover revision due to late-forming seroma and BIA-ALCL (the latter of which often presents with a seroma), Sientra is the only implant manufacturer that offers testing of late-forming seromas for BIA-ALCL, implant replacement for up to 20 years, and up to $7,500 of financial assistance for up to 20 years.
If you’re dissatisfied by how they look or want to change the style, shape, or size
Maybe you have buyer’s remorse regarding the results delivered to you by your surgeon or are so in love with your new shape that you’d like to upgrade to a bigger size. By now, you’ve likely noticed a trend in concerns that qualify for coverage by implant warranties—they’re related to your overall health. “If the patient has an issue with implant size or other similar subjective concerns, the warranty is not going to cover a revision,” says board-certified plastic surgeon Dr. David Shafer, who is based in New York City.
Should you change your implants when you get revision surgery?
In cases covered by warranty, your implants will be replaced with a free new pair. Doctors generally advise swapping in new implants when getting a revision, due to the increased risk of contamination. “I want to eliminate as many factors as possible, so I don’t take any chances by leaving the original implants in,” says Dr. Shafer.
If you and your surgeon decide to change your implants, it’s important to research the safety of the product options on the market. Sientra breast implants have been thoroughly studied for more than 10 years and are widely known for their unrivaled safety profile, which includes some of the lowest complication rates among common complications that can occur, such as rupture, capsular contracture, and reoperation.1,2,3
Should or must you go to the same plastic surgeon for breast implant revision surgery?
Depending on your reason for booking your revision surgery, you may want to go back to your original plastic surgeon or find someone new. Just be sure to do your homework regarding the surgeons’ expertise and take your consultations seriously. “We want to prevent the dreaded breast implant ‘revision cycle,’ where the patient is having revisionary surgeries every few years,” urges Dr. Gordon.
How long should someone wait after their initial breast augmentation to get an implant revision?
Though it’s easy to have a gut reaction regarding the look of your breasts post-op, know that it takes at least six months to see the final results. “Ninety percent of any issues raised by patients in the first few months after surgery self-resolve as the healing process is allowed to run its course,” explains Dr. Shafer. This is one of many reasons you should always schedule and attend follow-up appointments—your surgeon will be able to monitor you and determine if your breasts are healing correctly. If you’re truly unhappy with how your breast augmentation turned out, you’ll see the ultimate outcome of that surgery a year post-procedure, by which point you can schedule your desired revision procedure.
Does the breast implant revision surgery healing process differ from that of a breast augmentation?
Those who have gone through this experience already know that it can be a bit of a challenge, especially if your implant is placed beneath the muscle. (That first sneeze after surgery? Whew!) But every individual is different, as are their needs during a revision surgery. “Generally, any secondary surgery has an easier recovery than primary surgery,” says Dr. Shafer. After all, your surgeon can use the existing incisions and implant pockets, which may just need to be modified. But if you’ve experienced a significant issue with your initial implants, your recovery will look different.
Patients who experienced advanced capsular contracture may need a complete capsulectomy surgery, to remove the tough scar tissue around the breast implants, and the surgeon may use placement of surgical mesh, to prevent future issues. Similarly, if your implants migrated significantly, the pockets may need to be dramatically revised, with the incorporation of that surgical mesh, to inhibit any further tissue failure and keep your implants in the right place, says Dr. Gordon. Of course, an experienced, board-certified plastic surgeon will be able to work with you to determine the exact methods required to help you achieve your desired look, whether your breast implant revision surgery is covered under a warranty or otherwise.
Bottom line
Breast implant revision has a 93% Worth It Rating on RealSelf, making it one of the most popular plastic surgery procedures. It’s not uncommon to want or need a breast implant revision—implants aren’t lifetime devices, complications can happen, and your personal aesthetic preferences may change over time—but we know undergoing another surgery can be daunting. That’s why it’s so important to do thorough research first and find an experienced, board-certified plastic surgeon you trust, to best ensure a successful result.
Citations
Important Safety Information
Sientra’s Silicone Gel Breast Implants are indicated for breast augmentation in women at least 22 years old and for breast reconstruction. Breast augmentation includes primary breast augmentation to increase the breast size, as well as revision surgery to correct or improve the result of primary breast augmentation surgery. Breast reconstruction includes primary reconstruction to replace breast tissue that has been removed due to cancer or trauma or that has failed to develop properly due to a severe breast abnormality. Breast reconstruction also includes revision surgery to correct or improve the results of a primary breast reconstruction surgery. Breast implant surgery is contraindicated in women with active infection anywhere in their bodies, with existing cancer or pre-cancer of their breast who have not received adequate treatment for those conditions and, who are pregnant or nursing.
Key complications include capsular contracture, implant removal, rupture and reoperation. For more detailed information about the risks and benefits of Sientra breast implants, please visit sientra.com/resources or call Sientra at 888.708.0808. Sientra breast implants with High-Strength Cohesive silicone gel are only available through board-certified or board-eligible plastic surgeons.
The sale and distribution of this device is restricted to users and/or user facilities that provide information to patients about the risks and benefits of this device in the form and manner specified in the approved labeling provided by Sientra, Inc.
Sientra® and Platinum20™ are trademarks of Sientra, Inc.
