About implant revision
Revision covers a wide spectrum. At one end is a straightforward size exchange in a patient who is otherwise happy. At the other is a symptomatic capsular contracture requiring total capsulectomy, pocket reconstruction with acellular dermal matrix, and implant plane change.
Diagnosis comes first. We use MRI or high-resolution ultrasound to assess implant integrity, and clinical examination to grade contracture, define malposition and assess soft tissue cover. The operative plan follows from that rather than from a standard template.
Explant without replacement is an increasingly common request, and we support it without pressure to replace. Depending on tissue quality, explant may be combined with capsulectomy, a mastopexy to address the resulting skin envelope, and fat grafting to restore modest volume.
Who this suits
- Capsular contracture causing firmness, distortion or pain.
- Known or suspected implant rupture.
- Implant malposition, bottoming out, symmastia or visible rippling.
- A wish to change size, shape, or implant type.
- A wish to remove implants entirely, with or without a lift.
How the procedure is performed
- Imaging with MRI or ultrasound to assess implant integrity and capsule.
- Retrieval of original implant records where available.
- Total or partial capsulectomy depending on contracture grade and capsule thickness.
- En-bloc capsulectomy where clinically indicated and technically safe.
- Pocket revision — capsulorrhaphy for malposition, neopocket creation, or plane change from subglandular to dual-plane.
- Acellular dermal matrix or mesh support where soft tissue cover is inadequate.
- Concurrent mastopexy and fat grafting where explant leaves a loose envelope.
What it achieves
- Resolution of pain, firmness and distortion from contracture.
- Correction of malposition and restored symmetry.
- Improved soft tissue cover and reduced rippling.
- Full explant available for those who want implants removed permanently.
- A clear diagnostic workup before any operative decision is made.
Recovery timeline
Individual recovery varies. These are the stages most patients pass through, and the ones we plan your follow-up around.
- Days 1–3
Overnight stay usual. Drains commonly used after capsulectomy and removed once output falls.
- Days 7–14
Dressings reviewed. Desk work resumed. Garment worn continuously.
- Weeks 3–6
Swelling settling. Light activity, then progressive return to exercise.
- Weeks 6–8
Full activity. Upper body training resumed.
- Months 3–6
Final shape. Longer than primary augmentation because the tissue has been operated on before.
Cost
Highly variable with complexity. Simple exchange at the lower end; total capsulectomy with ADM support and mastopexy at the upper. Quoted after imaging and examination.
Bands reflect the genuine variation in complexity between patients. Your firm quote is issued after examination and does not change afterwards. See our full price list for context across the catalogue.
Frequently asked questions
Not always. A thin, soft, asymptomatic capsule often needs nothing. Thickened, calcified or contracted capsules do. We advise based on imaging and examination rather than a blanket policy.
Removal of the implant and capsule together as an intact unit. It is appropriate in specific circumstances, notably confirmed rupture of a silicone implant, but it is not necessary or safely achievable in every case.
Yes. Explant without replacement is a legitimate choice and we will not pressure you to replace. We will discuss honestly what the breast is likely to look like afterwards and whether a lift would help.
That depends on your original tissue, implant size and how long they were in. Some patients need nothing further; many benefit from a concurrent lift, and fat grafting can restore modest volume.
Regularly — it is a substantial part of our breast practice. Bring whatever operative records and implant documentation you have, though we can proceed without them.
