If you have previously had breast augmentation and something has changed – whether that is a complication, a shift in your goals, or simply the passage of time – attending a consultation for revision surgery can feel uncertain. You may be unsure what to expect, whether your concerns are significant enough to address, or how the process differs from when you first had surgery.
The short answer is that it differs quite substantially. This article explains what changes in the consultation and surgical planning process when a previous breast augmentation procedure has already been performed, and what Perth patients should understand before attending an assessment.
Why Patients Consider Revisiting Breast Augmentation
There are several reasons a patient may seek assessment for further surgery after a previous augmentation. Some of these are clinical, meaning there is a specific problem that needs to be addressed. Others relate to personal goals that have evolved over time. Common presentations include:
- Capsular contracture – where scar tissue around the implant tightens, causing firmness, discomfort, or a change in the shape or position of the breast
- Implant rupture or suspected rupture – requiring either confirmation through imaging or surgical assessment
- Implant malposition – where the implant has shifted from its original position
- Symmastia – a condition where the implant pockets extend across the midline of the chest, resulting in reduced separation between the breasts
- Significant asymmetry that was not present, or was less apparent, after the original procedure
- Rippling or visible implant edges, often associated with thin soft tissue coverage
- A change in personal preference regarding size, shape, or profile
- Implant age – older devices being assessed for removal or replacement
The specific reason for seeking revision directly influences the complexity of what is involved and what is realistically achievable. Outcomes vary between individuals depending on their prior surgical history, existing tissue quality, and the nature of the presenting concern.
What Changes in the Consultation Process
A revision consultation is more involved than a first-time consultation. This is not something to be concerned about. It simply reflects the additional information and assessment required to plan safely.
Reviewing Prior Surgical History
Before or during your consultation, Dr Hanikeri will seek to understand what was done previously. This includes the type, size, surface texture, and placement of the original implants, the surgical technique used, and whether any complications were documented at the time.
If you have implant identification cards, operative notes, or any records from your previous surgeon, bring these to your consultation. They can meaningfully reduce the amount of uncertainty involved in planning. If records are not available, that is manageable, but it does mean additional assessment steps may be needed.
Imaging Assessment
Depending on the presentation, imaging may be recommended before or after the consultation. Ultrasound is commonly used to assess implant integrity and surrounding tissue. MRI provides more detailed information and is sometimes recommended when rupture is suspected or the clinical picture is unclear. The recommendation for imaging is made based on your individual history and what is found during the physical examination.
Assessment of the Existing Capsule
When implants are placed, the body forms a natural capsule of scar tissue around them. This is a normal response. In revision surgery, the condition of this capsule – including its thickness, texture, integrity, and whether contracture has occurred – is one of the most important factors in surgical planning.
In some revision cases, the existing capsule may influence the surgical approach. In others, partial or complete removal of the capsule (capsulectomy) is considered. The approach to the capsule affects the complexity of the procedure, the recovery period, and the potential risks involved – all of which are discussed at consultation.
Pocket Assessment and Possible Pocket Modification
If the original implants were placed in a particular position – for example, above the muscle (subglandular) – and the revised plan involves placement below the muscle, this increases the surgical complexity considerably. Similarly, if the pocket has stretched, shifted, or contributed to malposition, surgical modification of the pocket may be required.
Procedures involving pocket repair or creation of a new pocket are technically more demanding than primary augmentation and carry their own set of considerations. This is discussed openly as part of the planning process.
Tissue Assessment
Previous surgery changes the tissue. Skin laxity, soft tissue thickness, and scar tissue from the original incision sites are all evaluated during the consultation. In patients who have had larger implants and are considering removal or downsizing, the skin envelope may not contract fully and a concurrent breast lift (mastopexy) may be discussed as part of the overall plan.
Implant Selection in a Revision Context
Selecting implants for a revision procedure is not the same as for a first-time augmentation. The altered pocket, the presence of a capsule, changes to the breast tissue itself, and the patient’s prior experience with a particular implant size or type all influence what is appropriate. It is not always possible to create a substantially different outcome simply by changing implant size, and this is a conversation that happens honestly at consultation.
Implant Safety Considerations in Revision Planning
For patients who had their original augmentation a number of years ago, implant safety is a relevant topic in 2026. The TGA has previously issued guidance on textured implants and their association with BIA-ALCL (Breast Implant Associated Anaplastic Large Cell Lymphoma), a rare condition that has been identified in patients with certain implant types.
If your existing implants are textured and you are attending for a revision assessment, this is worth raising specifically at consultation. Your surgeon can review your implant type and discuss whether any specific monitoring or action is appropriate in your case.
The Informed Consent Process for Revision Surgery
The informed consent process for revision breast surgery is at least as thorough as for primary augmentation, and in many cases more detailed, given the added complexity.
As part of this process, you will receive information covering:
- The proposed surgical approach and the reasoning behind each element of the plan
- The risks and complications specific to revision surgery, which may differ from those of primary augmentation
- What is realistically achievable given your prior surgical history and current tissue condition
- Recovery expectations, including any differences from your previous experience
- The possibility that further revision may be required in the future
In line with AHPRA requirements, there is a mandatory cooling-off period that applies to cosmetic surgery in Australia. Consent cannot be finalised during this period, and you will not be asked to make a decision on the day of your first consultation. This time is intended to allow you to consider the information provided, ask additional questions, and make a considered decision.
Choosing a Surgeon for Revision Breast Surgery in Perth
Revision breast surgery is generally more technically demanding than primary augmentation. When selecting a surgeon in Perth, it is reasonable to ask:
- Does the surgeon hold FRACS in Plastic and Reconstructive Surgery, or an equivalent specialist qualification?
- Does the surgeon have specific experience with revision procedures, not only primary augmentation?
- Does the consultation include a physical assessment – not just a discussion of goals?
- Is the surgeon operating at an accredited facility?
- Are all costs disclosed upfront, including anaesthesia, facility fees, and potential follow-up procedures?
It is entirely appropriate to seek a second opinion before proceeding, particularly for complex revision cases. A reputable specialist will not discourage this.
What to Bring to Your Revision Consultation
A well-prepared consultation tends to be more productive. Before attending, it helps to gather:
- Any implant identification cards or documentation from your original surgery
- Operative notes or discharge summaries if available
- A list of your current concerns – be as specific as possible about what has changed or what is bothering you
- A list of questions you want answered before making any decision
- Details of any imaging you have had (ultrasound, MRI) related to your implants
Frequently Asked Questions
Can I have breast augmentation revision with a different surgeon in Perth?
Yes. Patients are not obligated to return to their original surgeon for revision. What matters is that the surgeon you see has access to your prior surgical history where possible and has the experience to assess and manage the complexity of a revision case. Bring any documentation you have, and be prepared for a thorough assessment.
Is breast augmentation revision covered by Medicare?
In some cases, components of revision surgery may attract a Medicare rebate – for example, where capsular contracture is the clinical indication. Whether a rebate applies depends on the specific procedure being performed, the relevant MBS item numbers, and your individual circumstances. This is discussed at consultation once a surgical plan has been established. An out-of-pocket gap fee typically applies for the surgeon and anaesthetist fees.
How long does recovery from revision surgery take?
Recovery from breast revision surgery varies depending on the extent of the procedure. If the revision involves pocket modification or capsulectomy in addition to implant exchange, recovery is generally more involved than after a straightforward implant replacement. Your surgeon will provide specific recovery guidance based on the planned procedure.
What if I want my implants removed and not replaced?
Implant removal without replacement is a procedure in its own right. The outcome in terms of breast shape and skin contraction following removal depends on factors including implant size, how long the implants have been in place, skin elasticity, and whether any concurrent procedure such as a lift is undertaken. This is assessed individually at consultation.
What factors influence the surgical outcome of revision surgery?
The goal of revision surgery is to address the specific concern that brought you to consultation – whether clinical or personal. What is achievable depends on the condition of the existing tissue and the nature of the presenting problem. This is discussed honestly at consultation, with a realistic outline of expected outcomes. Individual results vary.
Next Steps for Perth Patients Considering Revision
If you are in Perth and considering revision breast surgery, attending a consultation is the appropriate first step. You will require a referral letter from your GP. A consultation with Dr Hanikeri involves a detailed clinical assessment, review of your prior surgical history, and a clear explanation of what is involved and what is realistically achievable.
Dr Mark Hanikeri holds FRACS in Plastic and Reconstructive Surgery and has been practising in Perth for over two decades, with a clinical interest in complex and revision breast procedures. Consultations are conducted at accredited facilities in Perth.
Further Reading on Breast Augmentation
- Breast Revision Surgery – markhanikeri.com/breast-revision-surgery/
- Breast Augmentation Perth – markhanikeri.com/breast-augmentation-perth/
- Breast Augmentation Techniques – markhanikeri.com/breast-augmentation-techniques/
- Correcting Implant Malposition – markhanikeri.com/from-symmastia-to-symmetry-correcting-implant-malposition-with-revision-surgery/
- When Should Breast Implants Be Reassessed – markhanikeri.com/when-should-breast-implants-be-reassessed/
- Breast Implant Removal – markhanikeri.com/breast-implant-removal/
| Written by Dr Mark Hanikeri – Specialist Plastic Surgeon, Perth WA. Dr Hanikeri holds Fellowship of the Royal Australasian College of Surgeons (FRACS) in Plastic and Reconstructive Surgery and has practised in Perth for over two decades. He consults and operates at accredited facilities and has a clinical interest in complex breast surgery including revision procedures. All content is reviewed for accuracy and AHPRA compliance. |
