Before your breast revision: what to gather, what to ask, what to decide

Documents to bring (or send in advance)

Not every patient has all of these. Bring what you have — partial information is still useful. The most important pieces are:

Operative report from primary surgery

The single most useful document. It tells the new surgeon exactly what was done, which incision was used, what implant was placed, and any intraoperative observations.

Implant card

Most patients receive an implant card after primary surgery — it lists manufacturer, model, size, profile, and lot number. If you don't have it, request it from the original surgeon's office. They are required to keep records.

Pre-op and post-op photos from primary surgery

Allows direct comparison of your starting state, intended outcome, and current state. If you don't have surgeon-supplied photos, your own pre-op selfies work fine.

Pathology reports (if any tissue was sent)

Relevant if you've had previous biopsies or any tissue removed during primary surgery.

Any post-op imaging

If you've had ultrasound, MRI, or mammography after primary surgery, bring the reports. This matters especially for capsular contracture or rupture concerns.

Photos to prepare for consultation

For an effective remote consultation, prepare four photos in good natural light:

1. Front view — arms relaxed at your sides, no bra, taken from chest level.
2. Front view, arms raised — same as above but with arms raised overhead. Reveals fold position, scar quality, and skin envelope.
3. Lateral view — side profile, both sides separately. Shows projection and upper-pole shape.
4. Three-quarter view — at 45 degrees, both sides. Reveals lateral displacement and fold dynamics.

Photos should not be edited or filtered. Plain background, neutral facial expression, natural light from a window. Avoid bright overhead lighting which casts misleading shadows.

Your implant card matters more than you think

The implant card contains specific information that changes revision planning:

• Manufacturer. Different manufacturers have different recall histories and capsular contracture rates.
• Surface type. Smooth vs textured determines plane considerations and BIA-ALCL relevance.
• Volume and profile. Allows precise comparison if you want to change.
• Date of placement. Helps assess implant age and rupture risk.
• Lot number. Important for any recall lookups.

If you don't have your implant card: contact your original surgeon's office and request a copy. They are obligated to keep records. If the practice has closed, contact the manufacturer directly with the date of surgery and your name — they may have records.

Questions to ask in consultation

The following questions reveal whether the surgeon has thought through your specific case:

• What do you think went wrong with my primary surgery?
• Which of the five revision categories does my case fit into?
• What incision will you use? Will you use my existing incision?
• Will you change the implant plane (e.g., subglandular to subfascial)?
• What size and profile of implant are you recommending, and why?
• Will you do a capsulectomy? Partial or full?
• Am I a candidate for single-stage revision, or do you recommend staging?
• What's the realistic outcome — and what's your honest opinion of what's not achievable?
• What's the probability I'll need another revision in 5–10 years?
• What's the recovery timeline, and how does it differ from primary surgery?

A surgeon who answers these directly, with case-specific reasoning, is doing the right kind of thinking. A surgeon who gives generic answers without examining your specific photos or records is not.

Pre-operative decisions you'll be asked to make

Revision involves more decisions than primary surgery because there are more options. Common decisions include:

Implant or no implant?

If you're considering explant, decide whether you want replacement or removal-only. Both are valid — but the decision changes the operation.

Capsulectomy: partial, full, or en bloc?

Partial = remove the affected portion. Full = remove the entire capsule. En bloc = remove implant and capsule together as one unit. Different indications, different surgical complexity, different costs.

Plane change?

If you've had recurrent contracture or visible rippling, your surgeon may recommend changing the implant plane. Decide whether you're willing to accept the additional dissection this requires.

Concurrent lift?

If your skin envelope has stretched, you may need a lift in addition to implant work. This adds scars but improves shape. Decide what your priority is.

Implant brand and surface?

Smooth, microtextured, or textured. Each has tradeoffs. Your surgeon will recommend, but the choice affects long-term capsular contracture risk and BIA-ALCL discussion.

Timing your revision

For most aesthetic revisions, wait 6–12 months minimum after primary surgery before scheduling revision. Tissues need time to settle, and what looks "wrong" at month 3 sometimes resolves spontaneously.

For symptomatic complications — pain, capsular contracture, suspected rupture — don't postpone. Symptoms generally don't improve with time and may worsen.

For BIA-ALCL concerns or implant recall — schedule promptly but with proper diagnostic workup first.

Practical scheduling: from the moment you've decided to proceed, allow 4–8 weeks for consultation, planning, and travel logistics. International revision patients typically book 2–3 months in advance.