Is a New Pocket Required for Revision?

I have subglandular tear drop natrelle cohesive gel implants 13mm wide. I am having them revised for 12mm wide implants due to a squared cleavage and visible edges. Can the new implant be placed in the same pocket or will I require a capsule removal? Do I risk rotation since the width is narrower? I only had my primary surgery 6mos ago...

Doctor Answers 5

Is a New Pocket Required for Revision?

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Thanks for the great question. It is impossible to give you specific feedback without more info, but here are some general guidelines for implant exchange pocket choice.

The same pocket may be considered if:

  • No issues with capsular contracture
  • Ample soft tissue coverage of implant

A new pocket may be beneficial if:

  • capsular contracture
  • implant visibility, rippling or wrinkling from thin soft tissue

Capsule removal is usually only necessary if there is ruptured silicone or capsular contracture. Too large of a pocket can increase risk of rotation with shaped implants. A board certified plastic surgeon can help you sort through these issues and recommend a plan to help you.

Best wishes,

Michael Vennemeyer, MD

Does Breast Implant Revision Require an new Pocket

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If you have thin breast tissue over your subglandular Natrelle tear drop implants then the squaring off you see may be due to implants that are two wide.  It may be more than just an implant width problem and you may want to consider using a smaller implant and placing it in the submuscular pocket.  Of course, you would need an exam to determine your best options.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Pocket revision for breast implant exchange

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There are really several aspects to your question. For one, "squared cleavage" may relate to the fact that the implants shaped, not specifically the width. Visible edges may relate to the fact that the implants are above the muscle, depending on which part of the implant this occurs on. If it is also in the cleavage area, the going under the muscle should be considered. Going to round implants rather than shaped implants could possibly help both issues. If you do use the same pocket, then a capsulectomy would be done in order for the new capsule to form adherent to the implants to minimize risk of rotation, but again this would not usually be necessary for round implants.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

Revision breast augmentation

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It is impossible to tell you whether or not the same pocket can be used without an exam. But in general for just an implant exchange the same pocket can be used.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Revisionary Breast Augmentation/Downsizing Concerns?

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Thank you for the question.

As you can imagine, it is not possible to give you precise advice without direct examination and a full communication of your goals.

 Some general thoughts may be helpful to you. In my practice, if the breast implant capsule is soft/normal, I do not remove it during revisionary surgery.  Whether or not some manipulation of the breast implant capsule will be helpful ( for example capsulorraphy)  will depend on whether you are experiencing any breast implant displacement issues.

In my practice, I generally prefer the use of round implants to eliminate the potential for breast implant rotation and resulting breast shape change ( potentially necessitating further surgery).

 I hope this helps.

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.