All About Secondary Breast Augmentation

February 11, 2022

There are a number of reasons you might choose to undergo a secondary breast augmentation, also known as a breast augmentation revision. Your body might have changed since your initial operation, sometimes as a result of pregnancy and breastfeeding, or simply because of the natural aging process. It could be that a number of years have passed and you’ve realized you’d prefer to go bigger, or smaller. Or you might be interested in removing your breast implants but still maintaining volume in the breast with fat transfer.

Whatever the reason may be for your interest, here’s what you need to know about secondary breast augmentation procedures.

Secondary Breast Augmentation After Your Body Changes

There are of course many different ways that our bodies change over time. When it comes to secondary breast augmentation, some of the top reasons patients come to see us is because they are interested in a revision after either pregnancy or after significant weight loss or gain.

Regardless of whether or not you have breast implants, pregnancy and weight loss or gain can really impact tissue structures in the breast, so this is not to say that these changes are exacerbated when an implant is present.

During pregnancy, hormonal changes and weight fluctuations will change the shape of breast tissue. After giving birth and breastfeeding, increases in volume typically resolve and can lead to sagging or deflated-looking breasts. Some women prefer to wait until after they’ve finished having children before they pursue a breast procedure, but that obviously does not work for everyone—some women are ready to get them earlier in life, and some aren’t sure if or when parenthood will be in their future. Plans change, welcomed surprises can happen, and let’s face it, life is straight up unpredictable.

All that being said, having kids can impact the results of a first surgery, and a secondary procedure can bring your breasts more in line with the look and feel that you want. After finishing breastfeeding, it can take several months for your breasts to settle, so it’s a good idea to wait a few months before booking a consultation with a plastic surgeon. That way you’ll get a better picture of what kind of surgical approach will best achieve the look you want.

Similarly, if you’ve lost or gained weight, your breasts may not look the same as when you first had your surgery. A secondary augmentation can help you achieve a look more in line with your body now.

Breast Implant Revision to go Bigger—or Smaller

Some patients come to us because they made a more conservative decision about the size of their initial breast implants, or the change in size was not as significant as they had hoped. Sometimes they’ve been happy for a number of years but want to go bigger now, while others have waited to see if their feelings might change with time. And some patients eventually decide what was once the right size is simply a little too small now.

A lot of people assume that someone would only want to go bigger or have no implant at all, but that’s definitely not the case. The opposite can also be true, where someone worrying they’ll regret going too small errs on the other side and chooses a breast implant that turns out to be too large, causing back and shoulder pain and a disproportionate look. They still would like more volume than they had to begin with, just not so much that it causes these kinds of problems (or pain!).

Simultaneous Implant Exchange with Fat

This is becoming a very popular procedure for patients who wish to have their implants removed but still want to maintain some fullness in their breasts. If you’re unfamiliar, you can also undergo a breast augmentation with fat transfer, but in this case we’re talking about replacing implants with fat harvested from other areas of the body.

It’s important to keep in mind that fat cannot achieve the same volume and upper pole fullness that a breast implant can. So if this is something you’re interested in, you need to have realistic expectations for your surgical outcome. Fat can only do so much—we can’t expect to remove a 400cc implant, replace it with 400cc of fat and achieve the same look. Unfortunately, it’s just not the same.

In some cases, your surgeon may suggest that you have a vertical breast lift in tandem with fat transfer. This results in a more significant scar, but it lifts the nipple and tightens the lower pole to create that natural-looking, lifted shape. We’ll also give you really specific guidelines that will help these scars to fade quite nicely.

Another important factor if you’re pursuing this surgery: you do need to have fat! It’s usually taken from the flanks or abdomen as that’s where “the good stuff” is, according to our team of doctors and nurses. It’s possible to take fat from inner and outer thighs as well. If you’re a thin patient, your surgeon may suggest that you gain some weight before the procedure so there’s enough to give your breasts the best possible outcome.

From a post-operative perspective, fat transfer to breasts causes significant bruising. Our superstar post-op nurse Lori tells us that it doesn’t really hurt at all, but it “looks like you’ve been hit by a truck.” And luckily, this goes away in a month. During that same month, you also can’t wear a bra because you need to allow the fat to settle and soften. Right after surgery, the fat remains very malleable, and a bra can easily crease or dent the fat.

If you still have questions, come see us.

Consultations are always free and we’d love to get to know you.