Situation where you need Breast Revision surgery
by Dr. Lee Joo Hyuk (KIES-U Plastic clinic in Korea)

You made a big decision to have a breast surgery, however, you might have a make another rather difficult decision for a revision surgery due to some problems such as capsular contracture, change in location, and severe asymmetric shape.

A situation as such would not be welcoming if you were to have a Breast Revision surgery.

Today’s post is on the Breast Revision surgery.

According to US FDA PMA Study, about 20% of all breast surgeries need a revision surgery. The study includes all the requested cases to the surgeons including the cases with saline breast implant, textured implant, and smooth implant.  (It could be assumed that the 20% figure could include rupturing of the saline bag as well)

However, the rate of re-surgery varies a lot from a surgeon to another. Some rate is about 1% and there are some that are much higher so a percentage figure might not have much meaning.

There is no reliable study that shows the percentage of revision surgery here in Korea.
Therefore, this post will be written according to my experience. I will include the details of those revision surgeries that I have completed, or I have been requested to do by other surgeons, foreign country cases and those that I have heard from other surgeons as well.

Majority of the breast revision surgeries are due to Capsular contracture.

Breast Implants

Judging whether a breast is pretty or not, depends on visual and tactile senses. This visual and tactile senses are negatively influenced due to capsular contracture.

There are at times when a person misjudges the capsular contracture. This is not when the breast becomes hard or stiff, or the implants becomes hard, but it is when the scar tissue capsule becomes hard.

So the surgery that is caused by the capsular contracture would include procedures that would get rid of the scar tissue capsule partially or completely.

Then the question would be ‘why does the scar tissue capsule become hard?’. There is no one who knows the answer to this question. When the breast implant and the skin meet, there is no interaction and this may have caused the stiffness.





The first thing that we do in the breast revision surgery due to the capsular contracture is to change the environment and conditions that lead to the aftereffects.

The breast implant can be changed if requested as well and also the pocket size determined in the 1st surgery can be changed as well. If the capsular contracture is rather severe, we can change the breast implant surface.

Usually, I do not remove all the scar tissue capsule around the implant. I think that the tightening of the capsule is due to the trauma that is caused on the skin to make room for the implant. So, by removing the scar tissue capsule completely, may cause a larger trauma on the skin.

Therefore it is important to minimize the trauma during the revision surgery, and remove only the necessary part of the scar tissue capsule, or chip small parts or the skin.

If the case is severe that the scar tissue capsule must be removed completely, it is advised to set a new surface for the room to input the breast implant.

It is important to have the techniques to minimize the trauma and to minimize the bleeding for the breast revision surgery caused by the capsular contracture.

I think that the less harm on the skin would lead to lower possibility of the recurrence.
Also, it is important not to have any blood clots after the breast revision surgery.
The surgery should not be performed so that the blood clot is necessary.

When the patients come in for revision surgery due to the capsular contracture, they are psychologically and emotionally unstable. They are at a desperate stage.

Can I trust that this would not happen again after the breast revision surgery?
Maybe I should have not had such as surgery before? Maybe this isn’t for me.
Why do I have to go through this difficult procedure again?
Many patients ask these sorts of questions in their minds.

My experience is that a lot of such patients go back home happily after they have the breast revision surgery due to capsular contracture.
There are those who feel more secure and happy about the result compared to the initial breast augmentation surgery.



Of course, it is not necessary that all the capsular contracture need a breast revision surgery.
First it is important to make decision on whether the breast revision surgery is necessary or not, if there is another problem other than the capsular contracture, or if there is some misjudgment on the result.

The serial photos can be a lot of help. If the photos show that the location or the shape of the implant change continuously, it is advised to get a revision surgery.

I usually have good results after the breast revision surgery. There might be recurrence of the capsular contracture but this was very low with about 0.1% in my experience.

The breast revision surgery must start from the lower line of the breast. We will talk more about this next time.

Today, we looked at the overall picture of the breast revision surgery caused by capsular contracture. Next time, we will look more about the situations where you might need breast revision surgery due to other problems.

Thank you for reading. Have a great day.