Breast implant revision — capsular contracture, malposition, exchange or removal

Breast implant revision corrects a hardened or distorted implant (capsular contracture), an implant that has shifted out of position, or a wish to exchange or remove implants. Dr. Khaled Ghalwash approaches it as reconstructive breast surgery — removing the tight capsule, repositioning, exchanging, or removing the implant and re-supporting the tissue — matched to the problem and to what you want.

Capsular contracture — the most common reason

The body forms a thin scar capsule around every breast implant. In some patients that capsule tightens and squeezes the implant, causing firmness, a higher or rounder position, distortion, or pain — graded Baker III to IV when it becomes visible or uncomfortable. The common threads behind it are a low-grade bacterial film on the implant, a small collection of blood at the first operation, or an individual healing tendency. Assessment also covers the implant surface type and, where relevant, BIA-ALCL surveillance — a rare condition linked to certain textured implants.

The revision options

Depending on the problem, the options include capsulectomy — removing the tight scar capsule — with exchange of the implant; repositioning for an implant that sits too high, low, or to the side; implant removal with or without replacement; or removal combined with a lift to re-support the tissue. Some patients choose explant — removal without a new implant. The plan is matched to your anatomy and your goals rather than to a single default.

Timing and what to bring

Capsular contracture, malposition, and an aesthetic concern are elective and planned once the breast has settled. An exposed, infected, or eroding implant is not elective — it needs prompt removal. Bring any change in shape, firmness, or pain to attention rather than waiting. For the consultation, bring your implant card or device sticker (type, size, surface, date), the operative note from your original surgery, and any imaging such as ultrasound or MRI — these confirm exactly what is in place and make the revision plan accurate and safe.

Frequently asked questions

What is capsular contracture?

The body forms a thin scar capsule around every breast implant. In some patients that capsule tightens and squeezes the implant, causing firmness, a rounder or higher position, distortion, or pain — graded Baker III to IV when it is visible or uncomfortable. Capsular contracture is the most common reason a breast implant needs revision.

What are the options for implant revision?

Depending on the problem, options include capsulectomy — removing the tight scar capsule — with exchange of the implant; repositioning for an implant that has shifted too high, low, or to the side; implant removal with or without replacement; or removal combined with a lift to re-support the tissue. Some patients choose explant (removal) without a new implant. The plan is matched to the anatomy and to what you want.

Why does capsular contracture happen?

The common threads are a low-grade bacterial film on the implant, a small collection of blood at the first operation, or simply an individual healing tendency. Assessment also covers implant surface type and, where relevant, BIA-ALCL surveillance — a rare condition linked to certain textured implants that is part of a thorough revision work-up.

How soon should an implant problem be treated?

Capsular contracture, malposition, and an aesthetic concern are elective — they are planned once the breast has settled. An exposed, infected, or eroding implant is not elective: it needs prompt removal. Bring any change in shape, firmness, or pain to attention rather than waiting.

What should I bring to a breast implant revision consultation?

Bring your implant card or device sticker — it records the type, size, surface, and date — together with the operative note from your original surgery and any imaging such as an ultrasound or MRI. These confirm exactly what is in place and make the revision plan accurate and safe.

Ask about a breast implant revision

Bring your implant card, operative note, and any imaging. We confirm what is in place and plan the correction — capsulectomy, repositioning, exchange, or removal — around your goals.

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