08/31/2026
When It’s Time for a Change: Revisional Breast Surgery
By Dr. Deborah Ekstrom
Orange County Plastic Surgery, Corona del Mar/Newport Beach
Just as our lives and priorities change with time, so do our bodies—and sometimes our aesthetic preferences.
This past week, we performed a number of secondary, or revisional, breast procedures. In fact, one sign of the maturity of our practice is that we now see a significant number of patients seeking revisional breast surgery rather than first-time breast augmentation.
Revisional breast surgery is often considerably more complex than the original operation. Previous surgery changes the anatomy. There may be scar tissue, stretched tissues, thinning skin, implant displacement or changes in the breast that have occurred with aging, pregnancy or weight fluctuations. As a result, revision procedures often require more surgical planning and operating time than a straightforward primary augmentation.
The reasons women seek revision are remarkably varied. Some simply have older implants and wish to exchange them for newer ones. Others have developed capsular contracture, an abnormal tightening of the scar tissue surrounding an implant that can make the breast feel firm, distort its shape or cause discomfort.
We are also seeing a definite change in aesthetic preferences. Years ago, many patients requested larger, more obvious breast augmentation. Today, the trend is frequently toward smaller, more natural-looking breasts. Some patients therefore choose to downsize their implants.
Other revisions involve correcting implant position or rebuilding the breast fold or implant pocket. In selected patients, we may use an internal support material such as GalaFLEX® to reinforce weakened tissues and provide additional structural support.
And some women simply decide that the implant chapter of their lives is over. They request complete implant removal, often combined with a breast lift to reshape the remaining natural breast tissue.
Successful revisional breast surgery requires experience, judgment and, frequently, a combination of techniques tailored specifically to that patient. Surgeons who develop a reputation for revision work naturally tend to attract increasingly challenging cases.
Time changes our bodies. It changes fashions. And it changes what we want for ourselves.
Fortunately, when those priorities change, we have more options than ever to help a woman achieve a result that better fits who she is today.
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