COVID-19 UPDATE: As of May 11, 2020, we have re-opened our office to regular in-person appointments. We are operating at a lower-than-normal capacity in order to respect social distancing advisories and best protect the health of our patients. We are still offering telemedicine as an option. For more information please call us at (314) 996-8800.


Replace or Enhance Breast Implants in St. Louis

Unlike diamonds, implants are not forever. Whether you got breast implants in 2012 or 2022—or anytime, really—if you need or want to replace or remove them, West County Plastic Surgeons can help. For breast implant revision surgery in the St. Louis area, experienced plastic surgeons Dr. Terry Myckatyn and Dr. Marissa Tenenbaum are a go-to choice. Both specialize in correcting or revising prior cosmetic or reconstructive breast surgery results, typically by removing or replacing the original saline or silicone implants.

Why choose breast implant revision? Our patients who elect to have the procedure do so to change the size or type of their implants and/or to correct any complications resulting from a prior breast augmentation surgery. The overall goal for breast implant revision is to restore a youthful breast contour and appearance, as well as to maximize the patient’s long-term health and comfort.

A breast implant revision may be performed for numerous reasons, both medical and cosmetic. Whatever the reason, at West County Plastic Surgeons of Washington University, we take great care in evaluating patients’ needs to ensure we provide cosmetic results that best suit their expectations. Our primary goals are safe and satisfying outcomes from breast implant revision, and we strive to ensure the best possible end results for every patient.

How Do Your Breasts Change After Implants?

Two of the most frequently asked augmentation-related questions our team hears are: “How do I know when my breast implants need replacing?” and “How long can you go without replacing breast implants?”

Even though modern implants are sturdy and don’t “expire,” they should not be considered lifetime devices. On average, breast implants can reasonably be expected to last anywhere from 10 to 20 years—and sometimes even longer! Even so, patients sometimes choose to have implants removed or replaced earlier because of cosmetic preferences or to address complications.

Even after you’ve had breast implants, your breasts will continue to change due to the natural aging process, weight fluctuations, hormonal factors, gravity, and other real-world factors. These changes may eventually prompt a desire for a change in order to address the new look caused by time.

Why Have a Breast Implant Revision?

Breast augmentation has a high satisfaction rate—which explains why it has remained one of the most performed procedures throughout the United States, even during the lockdowns and pandemic years of 2020, 2021, and 2022—and most patients are quite satisfied with their results. In rare cases, patients who are unhappy with the outcome may decide to have breast implant revision surgery. A breast implant revision may be performed for medical and/or cosmetic reasons.

Many people who choose to have breast implant revision surgery do so out of a desire to change the size of their implants, discomfort they’re experiencing because of capsular contracture, concerns about implants rupturing or migrating, or because they now prefer a different filling and style of implant.

Breast implant revision is appropriate for addressing the following breast conditions with surgical correction:

Bottoming out. This condition describes breast implants that have dropped considerably on the chest, making the implants look too low and the nipples look too high. One breast implant revision technique that corrects this problem is repositioning the implants and securing them with a biologic scaffolding material called Strattice.

Acellular dermal matrix is used to accomplish breast implant revision surgery at St. Louis' West County Plastic Surgeons.
"Bottoming out" is a common problem cited by patients seeking breast implant revision surgery at St. Louis' West County Plastic Surgeons. This problem develops when an implant migrates downward inside the breast itself, causing a bulge or elongation on the lower half. Using an acellular dermal matrix, our plastic surgeons can position and hold the implant higher internally, raising the breast crease and giving the breast a more natural, proportional, and youthful shape.
An illustration showing how Strattice™ can assist in correcting bottoming out.

Capsular contracture. It is normal for the body to form a capsule around a breast implant. This capsule is basically a form of scar tissue. Over time, however, this capsule can grow thicker, harder, and tighter, leading to a condition called “capsular contracture.” The changing capsule can squeeze the implant, causing it to change shape, which can result in visible distortion of the breast, discomfort, or both. Removing the scar tissue and implant via breast implant revision surgery resolves the problem. New breast implants placed in a proper position relative to the chest muscle provide attractive results and lasting comfort.

Implant downsizing. Some patients with implants may decide that they still want breast implants—but wish that they were smaller. Exchanging larger implants for smaller ones is very do-able, but the change in size often causes redundant breast skin and sagging breasts, also known as ptosis. As a result, downsizing via breast implant revision is usually accompanied by a breast lift procedure to remove the excess skin and maintain a perky look with breasts in an elevated position.

Dr. Terry Myckatyn, MD and Dr. Marissa Tenenbaum, MD

Dr. Terry Myckatyn and
Dr. Marissa Tenenbaum:

Trusted. Experienced. Committed.

Rippling. Particularly thin patients may find that rippling in a breast implant—a possible complication—can be seen as ripples on the surface of the skin. One option for treating visible rippling is to camouflage the ripples with the patient’s own fat using fat grafting. Another option is to pad the overlying soft tissues with a sheet of biologic scaffolding material called Strattice.

Ruptured Implants. All breast implants can potentially rupture or leak. A rupture is a tear or hole in the implant’s shell. Once this happens, the problematic implant can be removed and replaced with a new breast implant via breast implant revision surgery. When a saline implant ruptures, the implant may gradually or suddenly deflate like a balloon. The saline is safely absorbed into the body, but the size or shape of the implant—and therefore the breast itself—may change drastically.

Silicone implant ruptures are more difficult to spot because the thick gel leaks slowly. It may even remain inside the implant, or it may move into the surrounding tissue. Many patients won’t experience any symptoms if a silicone implant ruptures, but some patients do experience a decrease in breast size, the development of hard knots, uneven breasts, pain, tingling, swelling, or other side effects.

Symmastia or Synmastia. This condition occurs when breast implant pockets merge together across the middle of the chest. One way to correct this problem is to separate the two breast implant pockets with the patient’s own breast capsule material—provided it is strong enough—during breast implant revision. If it is not, an implanted biologic scaffolding material called Strattice™ may be used.

What Should You Expect from Breast Implant Revision?

Patients considering revision surgery often wonder: How long does it take to recover from breast implant revision? Here’s what you should know about breast implant revision procedure and recovery.

Anesthesia: Breast implant revision surgery is usually performed with the patient under general anesthesia.

Length of procedure: 30 to 150 minutes, depending on the type of revision required.

Estimated recovery time: Patients can usually expect to return to work after 1 to 2 weeks following breast implant revision surgery, and they should avoid vigorous activities for 3 weeks. Visible bruising should subside within 2 weeks, and swelling should begin to resolve within 3 weeks. To learn how to prepare for breast implant revision surgery at our surgery center and what to expect afterwards, click here to download our patient instructions.

Side effects: Common side effects after breast implant revision include bruising and swelling. The shape of the breast may change over time, and the final result may not be realized for a few months. Augmentation-mastopexy is associated with a higher rate of corrective surgery than either breast augmentation or breast lift alone.

Click here to download a detailed consent form from the American Society of Plastic Surgeons that lists the risks and benefits of breast implant revision surgery.

Which Procedures Complement Breast Implant Revision?

Patients often decide to combine breast implant revision with other similar breast-related procedures or other types of cosmetic surgery to maximize the aesthetic outcome. Some of the most common options include:

Breast Lift (Mastopexy)

A breast lift is sometimes combined with breast implant revision to elevate the breasts’ position by removing excess skin and re-shaping the breast contours. This restores a more youthful, uplifted breast shape.


Liposuction techniques—including tumescent liposuction, ultrasonic-assisted liposuction, and SMART laser-assisted liposuction—optimize overall body contours in relation to breast implant revision by reducing stubborn exercise and diet-resistant fat from specific areas, such as the stomach, thighs, back, flanks, and upper arms. This surgery sculpts contours, creating a more balanced body shape.

Tummy Tuck

Another area patients may wish to address is the abdomen. Muscle separation after pregnancy and sagging, excess skin due to pregnancy or massive weight loss are common concerns. Some patients choose to have breast implant revision in addition to a tummy tuck.

Mommy Makeover

Sometimes patients who want to address multiple areas choose to have a Mommy Makeover, which restores the body to a pre-baby shape. The suite of surgeries can include a breast procedure (such as breast implant revision), abdominoplasty, fat reduction, and more.

Before & After

Visit our Photo Gallery to see our patient results.

*Results may vary.

View Patient Results

Before-and-after photos of breast implant revision results: Click here 

If you have questions or would like to book a consultation with one of the surgeons at West County Plastic Surgery, please call (314) 996-8800.

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