Breast Augmentation Revision

On rare occasions, changes occur after breast augmentation that can cause you to feel less than completely satisfied with your results. There can be problems with regard to size, shape and position of the breasts as well as skin laxity. Also, as we get older, genetics, gravity and other factors affect the breasts and their position on the chest, often resulting in a saggy appearance. A top board-certified plastic surgeon, Dr. Rocco Piazza has specialized training in revisionary procedures to correct problems with the breast fold, malposition of the breast implants, and shape distortion. Dr. Piazza performs breast augmentation revision surgery in Austin for women from New Braunfels, Laredo, Wimberley, Dripping Springs, Kyle, and the surrounding area who want to correct these problems and attain a more aesthetically pleasing shape.

At The Piazza Center, we believe that beautiful surgical results are enhanced by following a healthy lifestyle. Our aim is to help you achieve your cosmetic goals and desires. If you would like to find out more about breast augmentation revision surgery in Austin, TX, you can request an in-person or virtual consultation online or call our office at (512) 288-8200.

Breast Augmentation Revision
 Before & After Photos


This feature contains nudity. Please click OK to confirm you are at least 18 years of age and are not offended by such material.

Reasons for Revision Breast Augmentation

Most women are very satisfied with their breast augmentation results and complications are rare. Still, age-related changes to the body can affect the appearance of the breasts over time. Additionally, the implants themselves are not designed to last forever, so most women will eventually need revision surgery even if they were initially happy with their results.

Common reasons for revision breast augmentation include:

Elective Implant Exchange

Many women choose to exchange their breast implants for various reasons. Women who have saline-filled implants, for example, often replace them with the newer generation of cohesive silicone gel breast implants or the highly cohesive gummy bear implants as these types of implants have more stability with their shape and fullness over time. In other cases, women decide they want either smaller or larger implants than they initially selected, or they want to change the implant placement from above or below the muscle. Most often, many of my patients notice that their breast volume has decreased after having children and desire to increase the breast implant size in order to restore the fullness to the breasts. Revision surgery is also an option for women who want to remove implants without replacing them.

Sagging or Loose Breast Tissue

This is one of the most common things that occurs to patients who had a breast augmentation procedure prior to having children. With pregnancy, the breast tissue around the implant oftentimes increases in size and stretches the skin. Whereas the augmented breast is usually firm and full before pregnancy, the breast tissue is now loose and droopy after having children, yet the implant remains high. A breast revision can tighten the breast, removing loose skin and reducing the size of the nipple and areola. A breast implant exchange can also be performed at the same time to restore the fullness that was lost after pregnancy and breastfeeding.

Visible Deformities

Rippling, symmastia (sometimes called “bread-loafing” or “uniboob”), and “double bubble” are among the visible complications that can occur after getting breast implants. These may be obvious soon after undergoing the procedure, or emerge gradually. In many cases, these deformities occur because an inexperienced surgeon doesn’t plan or execute the operation properly. An experienced and highly trained plastic surgeon, such as Dr. Piazza, can repair or re-create an implant pocket to correctly position the implants.

Capsular Contracture

This is the most common breast augmentation complication encountered by patients. After any breast augmentation procedure, the body naturally forms scar tissue around the implants, creating a capsule. In some cases, however, the capsule tightens and distorts the implant’s position or shape. In severe cases, it can be painful. Dr. Piazza corrects capsular contracture by removing this scar tissue, placing a new breast implant and oftentimes using an acellular dermal matrix like Strattice™ to significantly reduce the chance of recurrence.

Deflated Implant

Women with saline-filled implants notice immediately if one of them ruptures or leaks because it causes the breast to appear deflated. It’s a stressful–but usually harmless–situation that can be corrected with revision surgery. Ruptured implants filled with silicone gel often go undetected until the woman gets a routine imaging test. That’s because the silicone–filled implants maintain their shape even if they’re damaged.

Meet Dr. Piazza

Board-certified plastic surgeon Dr. Rocco C. Piazza looks forward to meeting with you to help you discover how you can achieve your cosmetic goals and desires.

About Dr. Piazza
Dr. Piazzas credentials Dr. Piazzas credentials

Your Custom Procedure

Breast augmentation revision surgery is can sometimes be a more involved procedure than the initial augmentation surgery. Dr. Piazza’s extensive training and experience performing enables him to create customized surgical plans based on a physical examination and the concerns you have about your breasts’ appearance.

The Consultation

Dr. Piazza asks about your aesthetic goals and explains in detail the types of results he can achieve through revision surgery. It’s important that you have a realistic expectation about your surgical outcome. Dr. Piazza spends as much time as necessary answering your questions and describes what he believes is the best approach to get the results you want. At the end of the consultation, you can schedule your surgery, which is performed at a fully accredited ambulatory surgery center near our office.

Real Patients. Real Stories

Helping Our Patients to Live Confidently

Find out what it's like to be a patient of The Piazza Center. Review the stories and "after" photos of some of the plastic surgery patients who've shared their experiences with us.

View Stories
Actual Patient Photo

The Surgery

Your breast augmentation revision procedure will take as little as 30 to 45 minutes or as long as 4 to 5 hours, depending on the extent of the corrections that need to be made. Generally, when performing revision surgery for breast augmentation, Dr. Piazza uses a combination of different techniques, such as performing a pocket change and adding an internal bra to support the implants, to correct the position of the implant and give better shape to the breast.

In some cases, Dr. Piazza combines a breast lift with the revision surgery. He’ll discuss this possibility during the consultation, as well, and talk about the incision options.

The Recovery

After the procedure, you may experience some soreness. This will decrease significantly during the next few days. Patients wear supportive bras after surgery and have follow–up office visits 1 week after their procedures. Dr. Piazza usually places all sutures under the skin, so he doesn’t need to remove them later.

In general, patients should be able to return to normal, everyday activities within 5 to 7 days after their surgery. This can vary depending on the extent of the surgery, so it is important to follow all post–operative instructions closely.

Breast Augmentation Revision at a Glance

Goal: To enhance the appearance of the breast after a prior breast procedure by refining the shape and volume of the breast. This procedure can also be used to treat capsular contracture or firm scar tissue around a breast implant.

Procedure: The incisions are usually planned to include the scars from the previous breast surgery. Oftentimes, Dr. Piazza will access the breast implant through a previous incision location by performing a scar revision of that incision. If a lift is needed to tighten and reposition the breast tissue, Dr. Piazza utilizes short-scar techniques to minimize scars while maximizing the result. Sometimes an “internal bra” is needed to provide support to the breast or reduce the chance of capsular contracture recurrence. Depending on the patient’s desired result, Dr. Piazza may use fat transfer to enhance the cleavage or correct any asymmetries of the breast. Sometimes, he will use drains to remove healing fluid in the early post-surgical timeframe to improve the result.

Anesthesia: General anesthesia

Procedure length: 2 to 4.5 hours

Aftercare: The breast incisions will be covered with small white Steri-Strips™. The patient will be placed in a soft bra if a breast lift or internal bra procedures is performed. Occasionally, the patient will have foam support on the sides of the breast or supportive tape on the skin. The patient should have someone at home for the first 24 hours after surgery. If needed, professional in-home nursing care can be arranged.

Recovery: During the first few days after surgery, the patient will experience some breast discomfort and pressure that usually can be controlled with medications that focus on pain and on muscle/chest tightness. Most patients will return to work 1 week after the procedure and resume full activities without restrictions after 6 weeks. Bruising around the breast in the areas where the lift or fat transfer was performed usually resolves by 2 weeks.


  • Surgery
  • Day 5 to 7: Steri-Strip removal
  • Day 6 to 12: Drain removal
  • Day 7 to 10: Return to work and social activities
  • 3 months: 80% healed
  • 6 months: 100% healed

Breast Augmentation Implant Exchange at a Glance

Goal: To enhance the appearance of the breast after a prior breast procedure by refining the shape and volume of the breast.

Procedure: When possible, Dr. Piazza prefers to utilize the scar from the previous breast surgery for this procedure to avoid creating new scar locations on the breast. The implant pocket can be tightened or adjusted during this procedure if needed. Depending on the patient’s desired result, Dr. Piazza may use fat transfer to enhance the cleavage or correct any asymmetries of the breast.

Anesthesia: General anesthesia

Procedure length: 1 to 2 hours

Aftercare: The breast incisions will be covered with small white Steri-Strips™. The patient may be placed in a soft bra, depending on the specifics of the surgery. Occasionally, the patient will have foam support on the sides of the breast or supportive tape on the skin.

Recovery: During the first few days after surgery, the patient will experience some chest pressure or tightness of the breasts. Most patients recover very well with acetaminophen and ibuprofen, which are 2 over-the-counter medications. Most patients will return to work 3 to 4 days after the procedure and resume full activities without restrictions after 6 weeks. Bruising is uncommon with this procedure but can sometimes be visible on the sides of the breast where Dr. Piazza has injected anesthetic medication or in the area where fat transfer was performed.


  • Surgery
  • Day 5 to 7: Steri-Strip removal
  • Day 7 to 10: Return to work and social activities
  • 6 weeks: 80% healed
  • 3 months: 100% healed

Dr. Piazza Answers Common Questions

After I have a breast augmentation revision procedure, will I need surgery again?

The goal with this procedure is to correct problems with each breast. Often, I am dealing with a number of complex problems, such as fold asymmetries and breast distortion, which can be very difficult to correct. I always tell my patients that they will ultimately have surgery again after having breast implants placed and that there are reasons for short–term re–operation and other reasons for long–term re–operation. The most important thing I want my patients to remember is that breasts change with age, just like the rest of the body. This is completely normal and expected, and therefore, surgery may be needed in the future. To learn more, read The Truth About Breast Implants: 10 Years Later in my blog.

Will I have to replace my implants at the time of my revision surgery?

It is likely that your breast implants will need to be replaced. This is dependent on a number of things. First, when were the implants placed? Second, are they silicone gel implants or saline implants? Is the implant shell intact? Are you happy with the size of your breasts? During a pre–surgery consultation with you, I will address these questions, as well as your cosmetic goals, to help you determine what is right for you.

How soon after my surgery can I resume exercise?

As with any surgery, it is important to follow all of your doctor’s instructions after the procedure in order to ensure that you recover as safely and quickly as possible. I usually tell my breast augmentation revision patients that they can resume exercise as soon as they feel comfortable. I prefer that they refrain from heavy lifting for the first few weeks, but I encourage them to get to the gym and walk on a treadmill or stair–step machine in the first week after surgery. I want my patients to get back to feeling like their normal selves as soon as possible. Returning to an active, healthy lifestyle can help achieve beautiful surgical results.

Melissa Cady, Anesthesiologist

Delivering an Exceptional Anesthesia Experience for Our Patients

At The Piazza Center, our patients come first. We have listened to our patients and in an effort to reduce the uncertainty with the anesthesia experience, The Piazza Center has developed a collaborative relationship with Dr. Cady to deliver an exceptional anesthesia experience for patients like you.

“By far the best anesthesia experience I've ever had. Thank you!!”

Learn more about Dr. Cady, D.O. and The Piazza Center’s approach to taking the fear and stress out of anesthesia.

Learn More

Is breast augmentation easier the second time?

This is a tricky question, and depends on the specifics of the procedure. It can be easier for the patient in that she knows what to expect and is better prepared. However, if you are adding a breast lift, going significantly larger, or require repairs to the implant pocket, your recovery might be more involved the second time around. For the surgeon, the same care and meticulous approach will apply whether it is a primary or secondary breast augmentation. The surgeon may encounter new challenges in a second breast augmentation, such as scar tissue or changes to the implant pocket, making the surgery more complex than the initial one.

How long is it safe to keep breast implants in?

There is no expiration date for implants. While the FDA in 2011 recommended replacing implants every 10 years, many women have kept their implants for 20+ years. Most surgeons will tell you that, if you are not experiencing problems with your implants, there is no reason to consider removing them. If it brings you peace of mind, you can monitor your implants with ultrasound or MRI imaging. The FDA recommends every other year starting 5 or 6 years after your surgery.

How soon after breast augmentation can you get a revision?

Most surgeons would recommend waiting at least 6 months before seeking a revision surgery. It can take this long for the tissues to soften and relax, allowing your implants to “drop and fluff.” Once you have fully healed and your final results are evident, then you and your surgeon can decide whether you want and need a revision procedure.

Newsletter Sign-Up