I believe getting breast implants is one of the toughest cosmetic surgeries. The patients not only have to go through a long recovery period of massaging and waiting, even the surgeon has an obligation to closely trace the development and results, our mood will change along with changes in the breasts, you could say the patient and doctor are both on the same boat. There are many reasons that can affect the results of breast implant surgery, and many things cannot be predicted in advance. If for any reason the patient is not satisfied with the results, that means pressure for the surgeon.

The reasons for an unsuccessful breast augmentation surgery can be separated into two categories; the doctor and the patient: 60% are because of factors of the surgeon, the possible reasons may be an improper choice of implant, wrong evaluation before surgery, or too much or too less separation space. 40% are due to factors of the patients, the reasons may be a prone to capsular body type, insufficient massaging after surgery, or lack of conditions for getting implants. Although no surgery is perfect, but if unsatisfactory results occur, we need to understand what circumstances are necessary to get revision mammaplasty.
If you have symptoms below, please do not worry, it has chancesto be improved with proper massaging:

1. Surgery was performed less than 6 months ago
2. The surgeon determines 1st to 2nd degree capsular contractions
3. Breasts are sometimes hard and sometimes soft, but there is still space for the implant to move
4. Height difference between the breasts are within 1 cm after surgery
5. When cleavage is gathered, the distance between the two breasts are within 1cm ( but this depends on the defined distance by the surgeon during surgery)
6. Although the wrinkles on the border can be touched, but the appearance looks normal.

But if the symptoms below occur, you may need to consider getting the breast implants redone:
1. After one year of surgery you are still not satisfied with the appearance of the implant
2. 3rd to 4th degree capsule contractions, or continued discomforts in the breast area
3. Height differences between the breasts are more than 2cm
4. Cleavage cannot be centered
5. Implant wrinkles can be obviously seen
6. Breast have a size difference of more than half a cup

Revision mammaplasty is always difficult, besides doing research on your own before surgery, it is also important to consult with different surgeons and ask for their opinions. I believe the majority of opinions are good opinions, getting the surgery the second time you would rather choose the safest and surest method, it is more important then the scar size, or relying on endoscope or other uncommon methods. As for the main points of the surgery, and what methods are available? I will explain the main points below:

1. Incision at the areola or lower breast line is safer than the armpit
For some patients who suffer from capsule contraction, an endoscope must be used to remove the capsules, otherwise, entering through the areola or underneath the breast line is the only way for complete and direct clean up, and is also the best way to prevent capsule contracture from forming again.

2. Capsule contracture cleaning is better than capsule contracture cutting
Capsule contracture removal is to completely remove the capsule that has formed inside the body, allowing the breast to regain its softness, and everything can start again. The capsule cutting method is simply to cut the capsule into squares and loosening it, but this does not solve the root of the problem, although this method shortens surgery time significantly, and can even be performed by inserting an endoscope underneath the armpit, but post surgery massages must me performed even more carefully to prevent it from becoming hard again.

3. Inserting under the muscle is better than the mammary gland or below the fascia
Because the breast of the patient has been enlarged for a period of time, the subcutaneous tissue will be thinner then normal, if the implant is removed from underneath muscle and placed over the muscle or below the fascia or mammary gland; the chances of the implant being touched or seen are extremely high. In other words, unless the surgeon believes the space underneath your muscles is unusable due to past procedures, otherwise spending more time removing the capsule and reinserting the implant, is better then separating the space above and reinserting the implant.

4. It is better to go bigger then smaller
Since the space has already been enlarged due to the previous implant, after cleaning out the capsule it will only be even wider and looser, therefore inserting a bigger sized saline water bag will allow the breast shape to look more beautiful and fuller. In addition a bigger implant is easier to massage, and it is easier to support the sides of the space.

5. Silicone gel implants are better than saline water bags
If contracture of the previous implant causes the wrinkles on the sides of the water bag to become more obvious, changing to a silicone gel implant can help solving this problem completely.

6. It may be necessary to separate surgery into different stages
For some special cases where serious capsule contracture appears quickly, or patients who had their implants inserted below the fascia yet have serious wrinkles, of they have loose skin due to previous surgery, may need to remove their implants and wait for recovery, and insert a new implant after a year or half a year.

I am sure by now you all have a better idea about the concepts and principles of breast implant surgery. Actually with the progress of modern breast augmentation surgery, performing the surgery the second time is not as tough, it is only necessary to clean off the capsule; the pain is even less then the previous surgery, and it will be softer, so you will cherish the results by performing chest regular massages. I believe through the hard work of the surgeon and the patient, you can accomplish the dream you had before of a perfect pair of breasts.