Breast Revision

In the United States and abroad, more and more women desire breast augmentation, and it is one of the most popular procedures for women. Sadly, many women need breast revision due to abnormalities with an original breast augmentation.  If you feel you have problems related to your breast surgery, Dr. Hankins Plastic Surgery is here to help patients.

Why do patients seek Dr. Hankins for their breast revision procedure? Some common problems encountered by patients viewed in our office include capsular contracture, bottoming out, implant rupture, lateral displacement of implants or the desire to either increase or decrease size. Dr. Hankins will discuss with each patient on an individual basis the severity of the problem and how to use breast revision to fulfill the needs of the patient.

Our  patients are requested to list what they like about their breasts, as well as the things they would like to see changed. This list then serves as both a working template for the rest of the consultation and for the actual revision breast surgery. It’s a great communication piece to follow between patient and plastic surgeon to achieve desired results.

Capsular Contracture

One of the most frustrating breast augmentation complications, for both the patient and the surgeon, is that of  capsular contracture where scar tissue forms around the implant that hardens over a period of time and becomes quite painful for the patient.  Typically a higher rate of this occurs when the implant was placed above the muscle. A  capsulotomy or capsulectomy sometimes needs to be performed – a release of the scar tissue (capsulotomy) or removal of the scar tissue (capsulectomy).

Bottoming Out Appearance

Gravity does affect breast implants; they can stretch leading to a bottomed-out appearance to the breast. Dr. Hankins highly suggests to his patients to wear supportive bras frequently as to not be faced with this problem.  Sutures are placed into the breast capsule around the breast implant, elevating the fold and re-elevating the implant to its normal position – cleavage is also improved at the same time.

Implant Rupture

Dr. Hankins does unfortunately still see patients in which their implants have ruptured. We still stress to our patients that the implants on the market today have very low rupture rates and are incredibly safe. One of the most common reasons for implant rupture is fold-flaw in which the implant keeps folding on itself repeatedly, causing shell delamination and weakness at the fold point. Dr. Hankins highly suggests that if a patient has a ruptured implant that it receive appropriate plastic surgery attention in the near future to lessen scar tissue and to reduce the likelihood of a problematic surgery.

Lateral Displacement

Our office has consulted breast implant patients that have commented their implant disappears into their armpit when lying down. This is another common problem that can be avoided if  during the primary breast augmentation the plastic surgeon uses careful pocket dissection. During breast revision surgery, Dr. Hankins can use lateral capsulorraphy sutures that help to recreate the lateral demarcation of the breast, preventing lateral splay of the implants, giving better inner cleavage.


Changing the size or volume of implants is a common request of patients. In the initial breast augmentation, a smaller size was placed , and now the patient would like a larger size/appearance. Dr. Hankins consults with each patient on this decision to make sure the right size and type, as the patient can change to either saline or silicone, is appropriate for the individual’s body structure.

Some women with age request or desire to have smaller implants due to a different lifestyle. By decreasing the size of implant, skin looseness is addressed by internally tightening the pocket or capsule surrounding the implant via a capsulorraphy to better fit the smaller implant.

If the implants are removed, a breast lift to restore the appearance of the breasts and decrease breast drooping and looseness of the skin might be necessary.