In regards to breast augmentation, are the risks higher with revision-augmentation patients than primary augmentation patients?

I was just reading an article and it said that the risks (rupture, capsule contraction, etc.) associated with breast augmentation are higher in revision-augmentation patients than they are for primary-augmentation patients; is that true? If so, why?

Doctor Answers 29

Risk for revision breast augmentation may be higher than for primary breast enhancement with implants.

Yes, it is true that the risk for re-operation after revision breast augmentation is higher than the risk for re-operation following primary breast augmentation for risks like capsular contracture and implant malposition to name a few. All three implant companies (Mentor, Allergan and Sientra) have shown this in the data they have presented to the FDA when they applied for FDA approval. A good resource for this information can be found on the FDA website.  Why... is a great question. As Plastic Surgeons we can assume that all tissue responds to re-operation by forming more scar tissue and the operation is definitely more complex. Be sure you choose a board certified Plastic Surgeon who has an expertise in primary and revision breast augmentation. 

Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Risks for revision breast surgery

Generally speaking, the risk of capsular contracture and rupture are not higher in revision breast surgery unless the revision is due to a capsular contracture.  The risks of asymmetry, infection, exposure of the implant may be higher.  The complexity of the surgery is certainly increased and requires expertise.

Samer W. Cabbabe, MD, FACS
Saint Louis Plastic Surgeon
4.8 out of 5 stars 43 reviews

Risks of Revision Breast Augmentation

On the whole, the risks for postoperative problems are greater in revisions than in primary procedures. This is because many revisions are for problems like capsular contracture. In these cases, because the tissue has already demonstrated a tendency to develop problems, this tendency still remains. When you operate on tissue primarily, there is no preexisting problem and a greater percentage of patients will have tissues that will respond favorably. If the revision is for a size change or some reason other than a complication, the risks are essentially the same as a primary procedure.

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 5 reviews

Revision Risk Breast Augmenation

It's great you're doing your research. There are variables to answering your question. The answer is dependent on the reason for the revision of the augmentation. If it is because of a complication, your risk goes up. For example, if there is a capsular contracture once, then the chance of another is higher. The surgeon who does the first procedure has healthier tissue to work with. Scaring and blood supply become more of an issue in a revision than in a primary case with any surgery. That being said, a skilled surgeon can still achieve good result with proper technique. I hope this helps!

Mary Lee Peters, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 110 reviews


Thank you for the question.

I believe that this really depends on the PS's experience, normally the results can be successful if they're done correctly. 

Dr. Campos

Jaime Campos Leon, MD
Mexico Plastic Surgeon
4.4 out of 5 stars 241 reviews

Breast revisions

It depends upon what the reasons are for the revision. If it is to increase your cup size that should have minimal risk. Going from a large cup size to a smaller can be more difficult without a mastopexy. Conditions such as  implant malposition, rippling and capsular contracture can be harder to treat but can be treated with good results. The key is to have a good surgical plan and to consult with a plastic surgeon who has extensive experience in breast surgery.

Mark Deutsch, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 28 reviews

Risks are related to the core reason for revision.

Risks associated with revision-augmentation correlate well with the the core reason to perform revisional surgery.  For example, a modest change of implant volume in an otherwise well healed previously augmented patient might predispose to few surgical risks, whereas implant change in a patient with established capsular contracture often predisposes to high risk of recurrent breast distortion.

Chen Lee, MD
Montreal Plastic Surgeon
5.0 out of 5 stars 16 reviews

In regards to breast augmentation, are the risks higher with revision-augmentation patients than primary augmentation patients?

Only in the since that the anatomy that has been disrupted is usually harder to correct for the surgeon.  In general, the revisions that I perform are nearly all successful, except in the case of capsular contracture as it is an incompletely understood entity.  I have found that the creation of a neopocket or total capsulectomy with an acellular dermal matrix reduces the rate of recurrent capsular contracture.

Find a board certified plastic surgeon who performs hundreds of breast augmentations each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.

Kenneth Hughes, MD

Los Angeles, CA

Are the risks higher with revision augmentation

Hi. Risks of revision augmentation are often significantly higher, depending on what the reason for the revision is and also what the surgery involves. Minor capsule release and change in size is a relatively low risk, but complete capsulectomy/pocket change/ exchange for leaking silicone etc have a much higher chance of problems such as rippling, especially if silicone granulomas have formed in the breast tissue, You should discuss this with your plastic surgeon.

Charles Cope, MD
Sydney Plastic Surgeon
5.0 out of 5 stars 5 reviews


Revision surgery is designed to solve problems with the primary procedure.
Capsular contracture rates are higher in patients who have had CC before, 
but capsulectomy, use of textured implants and changing implant from supra to sub-muscular position
can overcome this problem in many cases.
Rupture is not increased in revision surgery.
Infection and hypertrophic scar incidence should not change.
The reason higher rates are described for revision procedures is that the patients who
come in for revision surgery already have problems - so they are a selected subclass of patients
to start. For instance - patients who develop capsular contracture  have a 50% chance of recurrence,
so their rate is much higher than the unoperated patients who have a much lower rate.

John Strausser, MD
Sarasota Plastic Surgeon
5.0 out of 5 stars 3 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.