Breast Revision

Breast augmentation is consistently one of the most popular cosmetic surgeries performed worldwide. Doctors have been performing breast augmentation with implants for decades, and most patients are happy with their surgical results. However, breast implants are not permanent medical devices, and even in patients who are satisfied with their initial outcome, they may eventually need to be replaced. Dr. Mathew Mosher specializes in revision surgery for women who require a secondary breast augmentation surgery in the Vancouver, British Columbia area.

Revision Breast Surgery
 Before & After Photos


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Breast Revision vs. Breast Augmentation

Maintaining the desired appearance of your breasts after getting implants likely will require revision or maintenance surgery at some point. Breast revision surgery is more challenging, less predictable, and can be more likely to disappoint patients who undergo these procedures. Dr. Mosher has more than 20 years of experience in improving the outcomes for patients who are considering revisional cosmetic breast surgery.  

Patients are encouraged to discuss their need or desire for revisional cosmetic breast surgery with their original plastic surgeon. They will have the experience of knowing what surgery was done before and already have a relationship to build upon. However, it is common for patients to consider a second opinion or a fresh start with someone else, Dr. Mosher frequently is consulted in these more difficult and challenging situations.

In order to give you the best advice, patients are asked to provide a copy of any previous cosmetic breast surgery operative reports.  

Some of the considerations involved in revision surgery include gaining a good understanding of each patient’s goals. Scar tissue, physical and mental health concerns, details of the previous surgical procedures, including any implants that are involved, and the limitations that each patients anatomy places on proposed surgery.  Dr. Mosher will evaluate your goals, assess your tissues to be able to give you a realistic opinion on how to improve your results. When necessary, Dr. Mosher can also provide you an independent and compassionate opinion of what your options are and what types of improvements are achievable. Whatever your reasons for seeking revision surgery, Dr. Mosher and the team at YES has the experience and training to achieve the beautiful results you desire. 

Dr. Matthew Mosher

Dr. Mathew Mosher

Royal College-Certified Plastic Surgeon

As the Medical Director at YES Medspa & Cosmetic Surgery, Dr. Mosher takes great pride in helping patients understand their procedures, explaining the details and answering questions so that they are confident in their choices. Dr. Mosher and the rest of the experienced team at YES take a personalised approach to patient care utilizing experience and expertise sets them apart.

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Reasons for Replacing Breast Implants

In recent years, there are a growing number of reasons women seek out revisional cosmetic breast surgery. Some women are not satisfied with the results of their initial breast augmentation procedures. Size, shape, firmness, and symmetry related issues sometimes have been inadequately addressed. In other cases, the initial joy resulting from breast implant surgery has diminished with time. Aging of the breast shape, changes following pregnancyor weight fluctuations as well as changes in the visual goals are all common reasons for patients to visit YES Cosmetic Surgery Centre. Known complications that are associated with breast implants, including capsular contracture, implant rippling, malposition, pain, or implant failure, are other reasons to consider consultation.

Implant Rupture or Deflation

Newer breast implants are lasting longer and longer. However, deflation or rupture can occur, prompting the need for revisional surgery.  Silicone gel filled implants can rupture “silently”. This means that the breast continues to look and feel normal despite failure of the implant shell. Eventually a ruptured silicone gel implant will result in a change to the shape or feel of the breast. Statistically this is uncommon in the first five years after implantation. Patients with silicone gel filled implants are encouraged to have an annual physical examination by their family doctor or their plastic surgeon. In addition, an MRI or Ultrasound to assess implant integrity should be considered every other year, beginning 3-5 years after the original surgery.  MRI tests and High-Resolution Ultrasound exams are the most sensitive, but mammography can often also make this diagnosis.

Saline-filled implants, on the other hand, lose volume quickly when ruptured as the body absorbs the harmless saline solution. The resulting breast asymmetry makes the diagnosis of a ruptured saline implant quite straight forward. Patients are usually prompt at recognizing these changes and seek out consultation with Dr. Mosher.  Although there is no medical concern with this event, we try to accommodate patients quickly so we can discuss solutions. During the consultation you will be able to understand your options, explore if you are eligible for any assistance from your implant manufacturer, and then consider any recommended surgical correction. Dr. Mosher may recommend replacing the ruptured implant with a comparable one, recommend temporary removal of both implants followed later by re-augmentation or you may want to consider a different implant style or dimension. Some patients consider implant replacement surgery combined with other enhancements such as a breast lift to improve the position and distribution of the breast tissue, especially if the tissue and skin have been stretched with aging. Another adjunctive procedure that may enhance the results of revisional cosmetic breast surgery is fat grafting. Excess fat from another area of the body can be used to enhance the size of some or all your breasts, improve their symmetry or hide sharp edges and wrinkles at the time of revision implant surgery.

Unsatisfactory Surgical Results

Women disappointed with the results of their initial breast augmentation procedures may seek revision surgery to address their concerns. We always encourage patients to discuss their cosmetic breast revisional surgery needs with their original surgeon whenever possible. However, Dr. Mosher is frequently asked by patients and other plastic surgeons to consult with these patients.

It’s important to keep in mind that even the best breast augmentation outcomes change over time. Tissues become thinner and stretched, satisfaction with size and symmetry evolves, and nothing remains the same. These changes occur more quickly and more often with thinner patients, patients with larger volume implants, higher profile implants, and when a woman’s weight fluctuates.

Breast Augmentation FAQss

Get Answers to Your Questions

We understand that you may have lots of questions when you are considering breast augmentation surgery. For more in-depth answers to a wide variety of questions, visit Dr. Mosher’s Breast Augmentation FAQs now.

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Implant Exchange

Some breast augmentation patients opt to have their implants removed in order to upgrade to a newer type of implant. Dr. Mosher routinely performs revision breast surgery for this reason. Patients request newer versions of cohesive silicone gel implants, structured implants filled with saline, or sometimes traditional saline-filled implants are desired. Often, women choose to exchange their breast implants at our Vancouver-area centre because they would like to go larger or smaller with their breast size, or they want to address aesthetic issues such as visible rippling or asymmetry.

It is a misconception that implants need to be replaced every 10 years. If your implants are intact and you are satisfied with your breast aesthetics, there is really no reason to exchange your implants for newer versions. Cohesive silicone gel implants can rupture “silently,” so we do recommend an MRI or an Ultrasound of these implants to check on their integrity before making any recommendations. The choice to exchange implants for cosmetic reasons comes with pros and cons that Dr. Mosher will discuss with each patient.

Sagging and Stretching With Age

Even women who are very happy with the results of their breast augmentation will eventually experience some degree of sagging, thinning, malposition or drooping with age. Often the solution can be a breast lift to correct sagging (ptosis) or regain lost upper breast fullness. In some circumstances, a change in the implant size, type, or location is sufficient. Many factors influence the shape of your breasts. Determining the best approach to restoring and optimizing the shape of your breasts requires a thorough consultation that assesses your goals, your health, and your breast tissues.

Breast Implant Removal

Recently, many more women have been considering the pros and cons of permanently removing their breast implants and rely on Dr. Mosher to explain their options and the consequences of this surgery. Concerns about BIA-ALCL (Breast Implant Associated—Acute Large Cell Lymphoma), a very uncommon disease that has only been linked to specific textured implants, have prompted women to seek guidance from Dr. Mosher. At YES, we take the time to provide patients with up to date information, and then we agree on what to do next.

Breast Implant Illness (BII) is another motivator for women to consider implant removal. We try first to give patients accurate information so that they can make the best decision for their situation. Far too often, women have become anxious and convinced that their health symptoms are caused by their breast implants. There has been extensive and ongoing scientific research demonstrating that all currently approved breast implants are safe. There have been a few studies demonstrating a slightly higher rate of some autoimmune disorders and mental health disorders. Furthermore, there are more women with addictions, depression, and suicidal thoughts who have breast implants. In addition, there is a long list of non-specific health concerns that some believe are caused or made worse by their implants.  Although we may not be able to prove a link between breast implants and some illnesses, Dr. Mosher is supportive of women who want to have their implants removed. In these circumstances it is important to discuss the risks and benefits of implant removal and how best this should be done. When properly selected, women who have some unexplained health concerns can expect their symptoms to improve after implant removal in more than 50% of cases.

One technique that has been promoted for the management of women believed to have breast implant related health problems is “en-bloc” removal of their implants and their surrounding capsules. At YES, we educate our patients about what can be done as well as what should be done. En bloc removal is not recommended and it is not something that can be guaranteed to any patient by any surgeon. There is no study indicating that this surgical technique improves outcomes for patients. It has been demonstrated that this surgical technique unnecessarily increases the risks of complications from implant removal surgery without achieving any benefits. Dr. Mosher will perform your implant removal and when indicated the removal of the surrounding capsule using techniques that are backed by science, that optimize your outcome and minimize serious complications from surgery. When appropriate, tissue that is removed or fluids encountered during will be sent for laboratory assessment to provide information that will guide further recommendations.

Removed breast implants will be photographed, returned to the manufacturer when warranty assisted is appropriate or disposed of following provincial law.

Understanding your options, the risks of surgery, and the likely outcome requires getting an opinion from a plastic surgeon such as Dr. Mosher, who has extensive experience advising patients who are anxious about general health concerns related to their implants. Once you have had an opportunity to get all of your questions answered, a solution tailored to your needs can be considered. Removing breast implants for some patients can result in less discomfort, a more natural shape, improved proportion, or perhaps, improved general and peace of mind.

Worth the Wait

It’s natural to be eager to schedule your procedure once you’ve decided to get plastic surgery. Instead of rushing into the procedure, it’s worth waiting for an exceptional plastic surgeon such as Dr. Mosher who:

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Has earned a reputation for excellent results which has made him one of the most sought-after plastic surgeons in the Vancouver area

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Is dedicated to personalized patient care that consistently exceeds expectations

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Takes the time to understand your individual needs and aesthetic goals

Getting breathtaking results is worth the wait

The best plastic surgeons often have their calendars fill up quickly. Learn more about what to look for when choosing a plastic surgeon.

How to Choose a Plastic Surgeon

Fat Grafting to Re-Augment the Breast

Some of women considering revision breast surgery at YES Cosmetic Surgery Centre are interested in removing their implants and re-enhancing the size of their breasts with their own fat cells. Transferring unwanted fat from another area of the body to the breasts—a technique called fat grafting—has become a common option for breast augmentation patients at our practice. Fat grafting is not a new technique – it has been used for years to improve the contours of a patient’s face, breast, and body. Dr. Mosher has been performing this procedure on selected patients for more than 20 years.

Recent technique advancements, have resulted in a more predictable and safer outcome with this procedure. With that being said, transferring large volumes of fat isn’t predictable, so patients who want a significant increase in the size of their breasts are typically not a good candidates for breast fat grafting. Women seeking an increase of 1 to 2 bra cup sizes, or less than 200 cc of additional volume are often able to achieve this lasting enhancement using fat grafting. In most cases, a breast lift is performed along side fat grafting to the breast to improve not only the volume, but also the shape of the breast, once the implants have been removed.

A secondary benefit of fat grafting to the breast, is the opportunity to improve the shape of the other areas of the body where Dr. Mosher harvests the fat, such as the thighs, abdomen, or flanks. Experience and technique are essential components for successful and safe fat augmentation procedures.

How Is Breast Revision Surgery Performed?

Revision breast augmentation surgery is more complicated than the initial procedure, and it’s important to choose a Plastic Surgeon with experience performing these types of procedures. The techniques used during a breast augmentation revision depend on the specific reason a patient is seeking the surgery. One of the most common reasons for revision surgery is capsular contracture. This corrective surgery involves the release or removal of the scar tissue and replacing or removing the implants.

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The results of breast augmentation revision surgery aren’t as predictable as what you can expect after the initial enhancement procedure. That said, many patients are very satisfied with the outcome of revision procedures. A woman may choose revision breast augmentation to increase or decrease the size of her implants as her body and her goals change. More commonly, revisional breast augmentation surgery is done to improve unwanted outcomes such as implant malposition, visible rippling, scar contracture, asymmetries or sagging of one or both breasts.

You deserve to have the beautiful results that you expected from your initial breast augmentation. Whether you have experienced breast changes since your initial surgery, or you were unhappy with your initial results, Dr. Mosher can help you to achieve shapely and attractive breasts along with the best opportunity for a lasting result.

Women in and around Vancouver seeking revision breast surgery can request a consultation with Dr. Mathew Mosher, who specializes in these procedures. Or you can call YES Medspa & Cosmetic Surgery Centre at (604) 888-9378 to schedule your appointment.

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