In patients who have previously had implants, problems can arise over time due to the implant itself, the scar tissue surrounding the implant (capsule), or the overall appearance of the breast.

Firstly, implants are not lifelong materials, and they have a limited lifespan both on the shelf and within the human body. This period is generally considered to be around 10-15 years. Implants can rupture, exposing the silicone gel inside and causing inflammation. Implants can change shape or lose volume. Anatomical implants can rotate around their axis, leading to a distorted cosmetic appearance.

The human body forms natural scar tissue around the implant after it is placed. This tissue, called the capsule, can thicken over time, cause pain, and ultimately disrupt the external appearance. This pathological process is called capsular contracture.

The human body undergoes changes over time. The breast tissue and skin over the implant show changes due to years, aging, weight fluctuations, and, if applicable, radiotherapy, and the cosmetic result obtained when the implant was initially placed cannot be maintained in the long term.

Between the implant and the capsule, a fluid called seroma can accumulate over time. Seroma requires special attention as it can affect the appearance of the breast, lead to infections, and, rarely, indicate a precursor to a tumor (lymphoma). Your doctor will try to understand any problems related to breast implants and your expectations.

Your general health, smoking and medication use if any, other habits, allergies, and diseases will be discussed. Breast examination will be performed, measurements will be taken, the relationship between your breasts and nipples and your body will be evaluated, and the quality of your skin will be assessed. Photos may also be taken for medical documentation and planning.

In many cases, an imaging method such as Magnetic Resonance (MR) imaging may be requested to evaluate your breasts, the capsule, and the implant.

Treatment recommendations, information about surgery and recovery, and an explanation of possible risks and complications are also part of the consultation. It is crucial for the patient to understand the topic to keep their expectations in the right place. Patients should insist on understanding whether there are different options in their current situation, the possible risks, the recovery period, and any other questions that come to mind.

Implant revision, i.e., replacing the implant, represents a unique situation for each patient and needs to be individually planned and applied. If implants were used in the past for breast augmentation or reconstruction, and if you are dissatisfied with the appearance of your breasts and have concerns about the implant and capsule, you are a candidate for this surgery.

Being physically healthy and not smoking are essential for this surgery, as with any surgery. Breast revision surgery is highly personalized, planned for each patient, and includes general and specific risks that patients need to be aware of.

Risks associated with anesthesia, bleeding at the surgery site, seroma (fluid accumulation), non-healing of the incision, infection, and scarring are applicable to this surgery as well. Capsular contracture around the implant and the consequent development of pain and shape distortion, the rupture of the implant casing causing the gel to mix into the capsule or between tissues, persistent pain, changes in nipple sensation, visible implant from the skin, and change in the position of the implant are among the main complications that may be encountered after breast revision.

A type of lymphoma associated with implants (BIA-ALCL: Breast Implant-Associated Anaplastic Large Cell Lymphoma) has been identified recently. Whether this rare possibility applies to you should be discussed with your doctor.

In addition, a range of symptoms from skin rashes to joint pain and chronic fatigue has been intermittently associated with implants. In light of all this information, patients should understand that the possibility of carrying implants for a lifetime is not the same for every patient. Besides the mentioned risks associated with implants, deformities may develop due to disease, aging, weight changes, etc., and, similar to the current situation, patients should understand that, like their current situation, one or both implants may need to be replaced or removed.

Patients should be aware that they should not miss their follow-up appointments as recommended by the doctor, and in addition to clinical evaluation, imaging methods such as ultrasound or MR may be used if necessary. BIA-ALCL stands for Breast Implant-Associated Anaplastic Large Cell Lymphoma, describing a specific type of lymphoma that forms around the implant. It should be emphasized that this disease is not a form of breast cancer.

ALCL has been observed in patients who have used implants for both breast augmentation and reconstruction. At this point, the data largely points to textured implants, and the surface characteristics of implants seem to be the most significant factor contributing to the disease.

ALCL manifests as growth, swelling, masses in the breast, or under the arm, and fluid accumulation around the implant. The disease typically appears around 10 years after the implant is placed.

ALCL is a completely curable disease in its early stages. Therefore, it is important for patients who have had implant surgery for aesthetic or reconstructive reasons not to skip their check-ups.

These surgeries are entirely personalized, and no one's surgical plan may be exactly the same as another's. While existing incisions are likely to be the most probable site for incisions in your new surgery, depending on the reason for the revision, larger incisions than the old ones or completely different incisions in other areas may be considered. All these plans will be discussed with you before the surgery and will be shown to you with planning drawings. 

The surgery may involve not only the removal of your old implant before placing new implants but also the removal of a part or all of the capsule, which will be sent for pathological evaluation. Additionally, the region where your old implant is placed (submuscular/subglandular) can be changed.

The surgery may not only involve implant replacement but also lifting the sagging breast and nipple higher. At the end of the surgery, adhesive tapes, dressings, and medical bras may be used. The duration of use for all these items will be discussed.

There is a possibility of being discharged on the same day after breast revision surgery, but even if patients stay overnight, the hospitalization period usually does not exceed one night. In some cases, drains may be used to remove fluid and bleeding that may occur inside. Special dressings and postoperative bras are used after surgery. The duration of use for these dressings and special bras may vary depending on the technique used and the type of implant, and it should be discussed with the doctor during discharge.

Upon the physician's preference, short-term use of pain relievers and antibiotics may be recommended after the surgery. Pain generally subsides quickly, and the need for pain relievers usually diminishes on its own within a few days.

Usually, shower permission is granted 24-48 hours after the surgery. The return to activities such as sports, massage, and heavy physical activity mostly varies according to the surgical technique and the surgeon's preference. Generally, you should plan for a one-week period to return to your work life, but there is an average requirement of about three weeks for a complete return to normalcy.