Prior surgery. New chapter.
Breast revision covers the surgical correction, updating, or removal of prior breast work — whether that prior work was performed here or elsewhere. It is one of the more common categories of breast surgery at NCSS, because implants placed 10, 15, or 20 years ago behave differently than they did on placement day, and because aesthetic goals evolve. Revision is a legitimate, positive-framed procedure category — not a reflection on the prior surgery.
The presenting concerns typically fall into one of several categories: capsular contracture (scar tissue tightening around the implant), implant rupture or leak, size change desire (either larger or smaller), profile change (going from moderate to high, or high to moderate), aging with implants (implants that no longer suit the changed body), or desire for explantation (removal without replacement, sometimes with fat transfer or mastopexy for restoration).
Revision is technically more demanding than primary augmentation. Existing scar tissue, altered anatomy, and the specific implant history all matter. At NCSS, revision is performed by five of our affiliated surgeons, with Dr. Toohey leading the revision practice.
For the two most-searched subcategories, we maintain dedicated pages: Breast Implant Removal & Replacement (the exchange pathway) and Breast Implant Removal & En Bloc Capsulectomy (removal without replacement). This page covers the broader revision category and the modifications that don't fit cleanly into either dedicated pathway.
Who this procedure is designed for.
Breast revision addresses a wide range of prior-surgery concerns — from capsular contracture and rupture to size change, aging, and explantation.
Capsular contracture (Baker grade III or IV)
The most common revision indication. Scar capsule tightening produces firmness, distortion, or discomfort. When combined with a new implant, see our dedicated Breast Implant Removal & Replacement page. When you want the implants out without replacement, see Breast Implant Removal & En Bloc Capsulectomy.
Suspected or confirmed implant rupture
Silicone rupture is often silent and detected on MRI or ultrasound. Saline rupture is visible as deflation. Rupture almost always indicates exchange or removal — see our dedicated Breast Implant Removal & Replacement page for the exchange pathway.
Size or profile change (with new implants)
Size change (up or down), profile change, or style change (round to teardrop, textured to smooth) — all covered in detail on our dedicated Breast Implant Removal & Replacement page.
Aging with implants
Breasts continue to age around implants. Sometimes the implant itself is fine, but a mastopexy (lift) is needed to address descent that has developed over time.
Explantation (removal without replacement)
Removal without a new implant — often combined with mastopexy or fat transfer for volume restoration. This is a substantial category of its own; see our dedicated Breast Implant Removal & En Bloc Capsulectomy page.
Breast Implant Illness (BII) concerns
Some patients report systemic symptoms they attribute to their implants. Our full approach to BII-driven explant is detailed on the Breast Implant Removal & En Bloc Capsulectomy page. The short version: whatever your reasoning, if you want your implants removed, we will help you plan the surgery honestly.
Realistic expectations about scars and outcome
Revision often uses existing scar sites when possible, but new scars are sometimes required depending on what's being changed. Existing tissue changes affect the achievable outcome; primary augmentation results and revision results are different.
Smoking status matters — and approach varies by surgeon
Every surgeon at NCSS strongly recommends smoking cessation for at least 4–6 weeks pre-operatively. Smoking substantially impairs healing at revision incisions. Some of our surgeons, Dr. Nichter among them, will not perform surgery on patients who continue to smoke. Others will proceed with candid discussion of the elevated risks.
Every scheduled surgical patient is offered a free Rest-Assure pre-operative consultation with Dr. Rand Scott personally — medical history, medication planning, and discharge coordination before surgery day.
Three stages, one procedure.
Revision technique depends entirely on what's being revised. The most common technical elements:
Capsulectomy — partial or total
Removal of the scar capsule surrounding the implant. Total capsulectomy removes the entire capsule; partial capsulectomy removes only the abnormal or contracted portions. Choice depends on the specific problem being addressed.
En bloc capsulectomy
Removal of the capsule and implant together as a single unit, with the capsule kept intact throughout. Technically demanding; specifically requested by many explant patients and specifically indicated for confirmed BIA-ALCL or silicone rupture. See our dedicated Breast Implant Removal & En Bloc Capsulectomy page for full technical detail.
Implant exchange (any type)
Removal of the existing implant and placement of a new one — whether like-for-like or with size/profile/style change. Covered in full technical detail on our dedicated Breast Implant Removal & Replacement page.
Capsulorrhaphy (pocket repair)
Suturing to modify the implant pocket — used to correct malposition (bottoming out, lateral displacement, symmastia).
Explant with mastopexy
Implant removal combined with breast lift to address the skin envelope left behind. Common combined procedure; produces a lifted, restored breast without the implant.
Explant with fat transfer
Implant removal combined with autologous fat transfer to restore volume biologically. When Dr. Bednar performs the fat transfer, the same low-vacuum, microdroplet principles that define his primary fat transfer practice apply.
Site management for prior surgery elsewhere
When we don't have your prior operative report, we work from what your anatomy shows us. Revision technique is adjusted intraoperatively based on what we find.
Every Breast Revision at NCSS is performed under physician anesthesia — no CRNAs, no exceptions — in our AAAHC-accredited operating rooms.
Two sites. One recovery.
Recovery from breast revision is similar to primary augmentation for simple exchanges — and more involved for extensive capsulectomy or combined procedures.
Discharged the day of surgery with your dedicated nurse. Surgical bra worn continuously. Multimodal pain protocol.
Restricted arm movement (particularly overhead reaching). Most patients return to desk work at day 5–7. Drains occasionally used for extensive capsulectomy cases; not standard for simpler exchanges.
Progressive return to normal activity. Surgical bra continues. Some patients experience more prolonged tightness or discomfort than primary surgery, particularly after capsulectomy.
Return to full exercise once your surgeon confirms complete healing.
Final result becomes apparent as swelling fully resolves. Scars from revision often heal better than the original scars did, particularly when incisions are placed through prior scar sites.
Revision results are durable. Future revision may be needed at some point (implants continue to age), though many revised patients get another 10–20 years from their revised state. For explantation with mastopexy or fat transfer, results follow the same aging patterns as the underlying restoration procedure.
Every Breast Revision patient at NCSS is covered by our Rest-Assure program: physician anesthesia on the day of surgery, one nurse from arrival through discharge, and post-operative direct access to your surgeon — not an answering service.
Five surgeons. Revision experience matters.
Revision is technically demanding. Each surgeon page describes training, technique, and how to schedule a consultation.
Dr. Toohey
Revision Leader · Practice FocusAll-UC training; three decades of breast work; substantial revision practice volume across implant exchange, capsulectomy, and explantation.
View surgeon →Dr. Nichter
Full Breast ContinuumTriple-boarded; four decades in Newport Beach; revision as part of full breast practice.
View surgeon →Dr. Horowitz
Full Breast ContinuumEmory + UVA under Milton Edgerton; published breast surgery work; substantial revision experience.
View surgeon →Dr. Bernett
Female Surgeon · Full ContinuumUC Irvine trained; female surgeon offering the full continuum of breast revision.
View surgeon →Dr. Leong
Female Surgeon · Selective NCSS UseBrown-trained female plastic surgeon; revision as part of comprehensive breast practice.
View surgeon →The right starting point is a conversation.
Every consultation at NCSS begins with time — time to understand your goals, your health history, and which of our affiliated surgeons is the right fit for your specific situation.
Call (949) 644-8182Monday–Thursday, 8am–3pm · Friday by appointment only.
Related procedures.
Breast Implant Removal & Replacement
The dedicated page for implant exchange — rupture, capsular contracture, size or profile change, and combined mastopexy. One of our most commonly performed procedures.
Learn more →Breast Implant Removal & En Bloc Capsulectomy
The removal-only pathway — when you want the implants out without replacement. BII, BIA-ALCL, and permanent removal.
Learn more →Fat Transfer to Breast
The biologic option for volume restoration — often combined with removal (with or without implant replacement).
Learn more →