Breast Revision Double Bay, Sydney(Revision Breast Augmentation Mammoplasty)

The most common reasons for breast revision are capsular contracture, implant rupture or deflation, malposition, a change in size preference, visible rippling, and asymmetry.

Other common drivers include changes after pregnancy, breastfeeding, weight loss or gain, and the effects of ageing on the breast tissue around the implant. Some patients want implants out entirely, with or without a lift to restore shape.

Capsular contracture is the hardening of scar tissue (the capsule) that naturally forms around a breast implant. It is one of the most common reasons for breast revision surgery.

Surgeons grade it on the Baker scale from I (soft) to IV (hard and painful). Grade I and II usually need no treatment. Grade III and IV typically require a capsulectomy (removal of the thickened capsule), with the implant either exchanged or removed. The right approach is decided on a case-by-case basis at consultation.

Yes, in most cases. The surgeon has to work around scar tissue, an already altered implant pocket, and tissue changes left from the first operation, all of which add complexity.

Depending on what is going on, the procedure might involve a capsulectomy, pocket repositioning, an implant exchange, fat grafting, or a lift performed at the same time. No two revisions are the same; the surgical plan is tailored to your anatomy and goals after a thorough pre-operative assessment.

Daily activities are usually fine within 4 to 6 days, and most desk-based jobs are fine within the same timeframe.

Hold off on strenuous exercise, heavy lifting, and high-impact sports for around 6 weeks. Surface bruising and swelling ease within the first couple of weeks, though deeper swelling can hang around for several months. Expect the final shape somewhere between 3 and 6 months, once implants have softened into position. Dr Rastogi will give you a personalised timeline at your pre-operative consultation.

Yes, partly. Medicare may rebate breast revision surgery in Australia if it is medically necessary, but cosmetic-only revision is not covered.

Conditions that qualify for a rebate are capsular contracture, implant rupture, infection, or other health complications. There are MBS item numbers for procedures such as capsulectomy and implant removal; if medically required, patients do not need a GP referral. Some hospital and anaesthetist fees can also be partly covered by private health insurance, provided you meet the policy criteria. It’s worth ringing your fund to check eligibility and asking the practice about item numbers before you book.

Yes. A breast lift (mastopexy) is commonly combined with breast revision in a single operation.

This pairing is particularly common for patients downsizing their implants, removing implants without replacement, or whose breast tissue has dropped (ptosis) since the original surgery. Doing both at once avoids a second operation and a second recovery. The decision depends on breast tissue quality, nipple position, skin elasticity, and the reason for revision, all of which Dr Rastogi assesses at consultation.

In most cases, the surgeon can reuse the existing scar from the original breast augmentation, usually the inframammary fold under the breast.

If a lift is part of the plan, extra incisions usually sit around the areola, and with some lift techniques, there’s also a short vertical line below it. Most scars will fade and flatten over the first 12 months, provided you look after them well. Dr Rastogi maps out the exact incision pattern at consultation, factoring in your anatomy, where the old scar sits, and what the revision needs to achieve.

Most patients should wait 6 to 12 months after their original breast augmentation before having revision surgery.

Waiting this long lets the swelling settle, gives the implants time to drop into their final position, and lets the breast tissue heal enough for the result to be properly assessed. An earlier revision is sometimes needed for serious issues like implant rupture, significant infection, or a haematoma, and that surgery may be planned within weeks. The right timing is confirmed at the consultation based on your individual situation.

The signs of a ruptured breast implant depend on whether the implant is saline or silicone. A saline rupture is usually obvious; a silicone rupture is often silent.

When a saline implant ruptures, it deflates over hours or days, and the breast loses obvious volume. With modern silicone implants, the cohesive gel tends to stay put, which is why most silicone ruptures produce no immediate symptoms. Later warning signs can include a change in breast shape, new firmness, swelling, tingling, burning, numbness, or pain. As a silent rupture cannot be picked up by examination alone, the TGA and FDA both recommend ongoing imaging (ultrasound or MRI) for silicone implant patients.

Breast implant illness (BII) is a term used for a group of systemic symptoms reported after breast implant surgery, such as fatigue, brain fog, joint pain, rashes, hair loss, and anxiety. It is not yet a formal medical diagnosis.

The TGA acknowledges these patient reports, but no single test confirms BII and symptoms can appear with any implant type. Some patients who have their implants removed (with or without capsulectomy) notice partial or full symptom improvement, while others do not. A consultation is the best way to decide if implant removal is reasonable for you, and any underlying medical issues should also be reviewed with your GP.

Yes. Many revision consultation patients had their original breast augmentation performed by a different surgeon, in another state, or overseas.

It helps to bring as much information as possible to the consultation, ideally the original operative report, hospital records, and the implant identification card showing brand, size, profile, and serial numbers. When those records are unavailable, the surgeon will rely on physical examination and imaging, such as ultrasound, to assess the implants and surrounding tissue. A revision after overseas surgery is a routine part of clinical practice in Australia, and Dr Rastogi will explain the options at his consultation in his Double Bay rooms.

After implants are removed without replacement (explant surgery), the breasts will look smaller and softer, with some loss of upper-pole fullness.

The final shape depends on how long the implants were in, implant size relative to the natural breast tissue, skin elasticity, weight, age, and pregnancy or breastfeeding history. Many patients are happy with the more natural look after explant alone. Others choose to combine explant with a breast lift to reshape the tissue, or with fat transfer to restore some volume. Likely outcomes for your anatomy and goals are reviewed in detail at consultation.

An en bloc capsulectomy is the surgical removal of a breast implant together with the surrounding scar capsule in one piece, without opening the capsule.

The aim is to keep any implant contents (silicone, calcifications, or biofilm) sealed inside the capsule during removal. Surgeons typically recommend it for confirmed or suspected BIA-ALCL, severe capsular contracture with calcification, ruptured silicone implants where gel has spread beyond the capsule, and for patients who specifically request the technique because of BII concerns. En bloc is more involved than a standard capsulectomy and carries slightly higher risk, including a small chance of injury to nearby structures such as the chest wall or pleura. Whether it is appropriate is a clinical judgement based on implant location, capsule condition, and the reason for surgery.

Any surgical or invasive procedure carries risks. Before proceeding with breast revision surgery, you should seek a second opinion from an appropriately qualified health practitioner. Not every patient is suitable for breast revision, and a thorough consultation, including a discussion of your medical history, expectations and psychological wellbeing, helps determine whether the procedure is right for you. In some cases, an assessment by your GP, a psychologist or a psychiatrist may be recommended before going ahead.

A GP referral is required before your consultation for cosmetic breast revision surgery, in line with current AHPRA requirements. If the revision is medically required (for example, capsular contracture, implant rupture or BIA-ALCL), a GP referral is not required under the AHPRA guidelines. However, one is still needed for any Medicare rebate.

A minimum 7-day cooling-off period applies between your consent and the date of surgery for adults, unless the surgery is medically required. For patients under 18, a 3-month cooling-off period applies, along with a GP referral and assessment by a registered psychologist or psychiatrist.