Issues that require surgical attention include capsular contracture (the constricting of the implant by excess scar tissue), visible rippling, bottoming out, and implant rupture.

To treat capsular contracture, Dr. Parkins can release or remove the scar tissue that has formed around the implant, allowing the device to return to its natural shape. This breast revision technique resolves the hard and blocky appearance that a constricted implant takes on.

• Rippling can occur when implants are not filled properly, they sit too loosely in the breast pocket, or there is not much tissue covering them. The wavy surface of a rippled implant can cause the skin above to look the same way. Removing the implant during breast revision and replacing it with a properly filled device that sits snugly in the pocket can solve the problem.
  
• Bottoming out is an issue that can be experienced by patients who have had a lift performed alongside augmentation with implants. While excess skin can be removed via surgical excision, there are also other conditions that can cause breasts to droop. In these cases, removing the loose skin alone won’t provide a lasting improvement in breast position. As they heal, patients may notice their implants have sunk lower inside the breast itself so that the top of the breast is no longer so full and the distance from the nipple to the breast crease is disproportionately long. To correct this defect, Dr. Parkins improves supportive internal breast structures during breast revision to better hold the weight of the implant.
  
• All implants have a “shelf life,” which means they may someday, years down the line, develop a tear. If this happens to a saline implant, the breast will appear deflated as the sterile salt water solution inside the silicone shell trickles out and is absorbed into the body. Since silicone is thicker, ruptured gel implants do not flatten, so women with these augmentations should be routinely evaluated to determine whether a rupture has taken place. In either case, damaged implants are removed and replaced during breast revision to restore your appearance.

It may be time to consider breast revision if you feel physically uncomfortable or if your implants are causing you emotional distress. In other cases, the need may be very obvious—as when a saline implant ruptures or capsular contracture develops—or apparent after follow-up care reveals a tear in a silicone device.

Dr. Parkins advises patients to wait six months to a year after an augmentation procedure before they decide they want breast revision surgery. While this may seem like a long time to live with implants you don’t like, it’s important to give the healing process ample time. About a year after augmentation surgery, breast implants naturally drop and soften. Swelling is also greatly reduced. If you are dissatisfied with breasts that appear high and firm right after surgery, you may change your mind as the results mature and reveal their long-term position, shape, and feel.

Implants can cause some women to watch their larger and heavier breasts sag over time as gravity pulls and stretches aging skin. A breast lift can address this problem and pairs well with breast revision procedures. Talk to Dr. Parkins about the possibilities if you are unhappy with the look of your breasts, for whatever reason.