Thank you for the question.
Although there is a lot of mis information (myth) regarding breast implant replacement the rule of thumb is: “if it ain't broke don't fix 'em".
In other words, if the patient is doing well and has had no problems with her implants (such as leakage, encapsulation, malposition, asymmetry, rippling/palpability, dissatisfaction with size/shape/position etc.) or her breasts (such as cancer, trauma, or change in size/shape/position) there is no indication to remove or remove/replace the implants.
Relevant to this topic is AVOIDANCE OF COMPLICATIONS that may necessitate further breast implant surgery (revisionary surgery). Some suggestions I am able to offer:
1. Make sure you are doing the procedure for the right reasons (for yourself) and that you have realistic expectations. Be aware that an improvement in the “problem area” may not translate to an overall improvement in your life situation. You are bound to be disappointed with results of the procedure if your motivation for doing the surgery is not internally driven.
2. Make sure you have your surgery done by a well experienced board-certified PLASTIC SURGEON. You should be aware that there are surgeons, not formally trained in the field of plastic surgery, who will offer to do your breast augmentation surgery. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing long-term well-placed breast implants.
3. COMMUNICATE your goals with your surgeon. In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" or "top heavy" means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate.
I use intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
By the way, the most common regret after this operation, is “I wish I was bigger”.
4. Choose the position (preferably sub muscular) and the type of implant used carefully. These choices may determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have. If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants. If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.
On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference. Patients may need an MRI to diagnose a silicone gel rupture.
5. Time your surgery as carefully as possible. in general, if you can avoid significant weight gain/loss after the breast surgery you will improve your chances of not needing further surgery. Pregnancy and breast-feeding will also potentially cause changes in the size/shape/position of the breasts that may necessitate further surgery to correct.
Following these guidelines may help in reducing the chances the further surgery will be necessary; however, realistically speaking most young ladies undergoing breast augmentation surgery will likely need some type of revisionary surgery during their lifetimes.
I hope this helps.