Stephen McCulley, Reconstructive and Aesthetic Surgeon. MBChb, FCS(SA)Plast, FRCS(plast)

What to expect from having a second breast augmentation

  1. To go smaller
  2. To go bigger
  3. Implants need replacing due to complications
  4. Your body shape has changed

Why do patients have a second breast augmentation?

1. To replace existing breast implants with smaller implants.

This could be because you:

  • have lost or gained a significant amount of weight so the implants are no longer proportional
  • feel the implants look or feel too large
  • are experiencing pain, such as backache, from having large implants

Some patients choose to have their breast implants removed without replacement. This could be due to personal preference or because of complications such as implant rupture or capsular contraction.

If the skin has been stretched and your breasts are sagging as the result of having had breast implants, then your surgeon may perform a breast lift as part of your implant removal surgery.

2.  To replace existing breast implants with bigger implants

You may decide to have a second breast augmentation to increase the size of your breasts. Patients usually choose to have bigger implants because their breasts are smaller than they expected after their initial operation.

Alternatively, you may be happy with the size of the implants but not the profile as you may feel your breasts project too far forward or not far enough from your chest.

3.  Your implants need replacing due to complications

Although it’s rare, you may find your implants need replacing due to complications.

The most common complications that require a second procedure are:

  • Capsular contraction–hard scar tissue forms around the implant, causing the implant to feel hard and look uncomfortable.
  • Implant rupture–a tear or hole in the implant shell causes the saline or silicone solution to leak from the implant. You can find out more about breast implant ruptures, including symptoms to look for, here.

The above complications can happen at any point after having breast augmentation surgery. However, 50% of breast implant ruptures occur in implants that are over 15 years old. Although most manufacturers state that breast implants will last for ten years, many women will find their implants last much longer.

4.  Your body shape has changed

Dramatic weight loss or gain could affect how your implants look as your body shape will have changed. Losing a lot of weight could mean your implants now look too large for your body, or you may benefit from a breast lift and augmentation if your breasts are sagging due to weight loss.

Pregnancy and breastfeeding will change the shape of your breasts, whether you have implants or not, as weight gain and hormonal changes can increase breast size.

A study has shown that breastfeeding after having an augmentation is not a significant cause of sagging breasts. However, the rapid weight gain and loss associated with pregnancy can cause breasts to sag, this happens whether or not you have implants.

It can take several months for your breasts to settle after breastfeeding, so if you’re concerned about the shape of your breasts after pregnancy and breastfeeding then it’s best to wait a while before considering having a second breast augmentation.

What to consider before having a second breast augmentation

If you’ve had breast implant surgery in the last 6 months, then your surgeon will probably advise you to wait a little while before having a revision.

This is because:

  • Swelling after a breast augmentation can take a few of months to fully settle so it may take a while before the results of your surgery are fully realised.
  • If you’ve had implants inserted under the chest muscles (sub-muscular), then it’s normal for these to take a little longer to settle, around three to six months.
  • It can take time for you to get used to how your new breasts look and feel.

How much will a second breast augmentation cost?

You may be charged less for breast implant revision surgery if you go to the surgeon who did your original breast augmentation.

However, there are multiple factors involved in determining the cost of breast augmentation surgery:

  • Your breasts may need lifting to accommodate the new implants.
  • The ‘pocket’ where the implants are inserted may need adjusting.
  • Moving the implants behind the chest muscle, instead of in front of the muscle, can have added costs.
  • Whether the procedure is to correct a complication, or it’s an elected procedure to increase or decrease the implant size, will affect the cost.

Speak to the surgeon who did your first procedure to find out what’s involved in a second procedure and how much this is likely to cost.

What are the risks of a second breast augmentation?

This depends on why you are having the surgery. Replacing existing implants for moderately larger or smaller implants is relatively straightforward. If you’re having surgery to correct a problem, such as a rupture or capsular contraction, this could make it risker.

Is a second breast augmentation less painful?

Many patients find they experience less pain after a second breast augmentation when compared to their first procedure.

Your surgeon may be able to remove or replace the implants without creating a new pocket. This is because your surgeon will have made the incision that creates the ‘pocket’ where the breast implant sits during your first surgery. This can reduce discomfort considerably and means you have a shorter post-op recovery time.

If your surgeon needs to reposition your breast implants, for example if your existing implants are in front of the muscle, and your new implants are inserted behind the muscle, then you can expect the pain and recovery time to be similar to when you had your first augmentation.

What next?

If you’re considering a second breast augmentation to change the size or shape of your implants, or if you’re experiencing symptoms of a rupture or capsular contraction, then contact Stephen McCulley for advice.  

Our page on breast implant ruptures provides detailed information on how to tell if your implant has ruptured and what to do if it has.

If you’re unhappy with the size of your breast implants but are unsure of which cup size is right for you, read our guide to choosing the right cup size for your augmentation.