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Breast Revision


Breast augmentation using implants is one of the most common cosmetic procedures in the U.S., and in most cases, it creates outstanding outcomes. Unfortunately, sometimes a patient can be dissatisfied with the appearance of her breasts and may need breast revision treatment. Keep in mind that not all breast revisions are because of surgeon error. While a few breast augmentations do end with an undesirable outcome, there are individuals who want a larger or smaller implants. Some patients may desire their implants be removed due concerns such as pain and capsular contracture. Furthermore, some women need revision treatment for a unique condition. Dr. Ryan Couvillion, a plastic surgeon in Houston, TX, performs breast revision surgery after giving an in-depth evaluation at SBA Dermatology so that the correct outcome is delivered. It is also important to understand that the results of breast augmentation are not permanent and that they may require replacement or revision. This is because as time passes, the shape of a person’s breasts can change due to factors such as aging, weight changes, and the hormonal changes related to pregnancy.


"Dr Couvillion kept me talking through my procedure and kept me distracted and was wonderful. His staff is also wonderful. I truly recommend him for any procedure."

- T.L. / Healthgrades / Aug 07, 2019

284 Total Reviews



Should you have any issues (either medical or cosmetic) after breast augmentation, please make a consultation with Dr. Couvillion to discuss your needs and wants and to determine your custom breast revision surgery plan. Whether it's scar tissue, breast drooping, ripples under the skin, or breast asymmetry, revision surgery can help correct the irregularity and provide a more pleasing and properly functioning outcome. This operation may also be appropriate if you want to alter the implant style, size, or address another aspect of your breasts.


This cosmetic surgery is an option to replace or remove an implant that is not functioning properly or is no longer desired. Breast revision surgery may also be performed to change implant size or go from saline to silicone (or vice versa). Over the passage of time, if you become unhappy with the appearance of your breasts, you may choose to undergo a revision or implant exchange to restore a healthier appearance. 


This condition occurs when the implants look uneven. This may be due to an incorrect size implant or sagging on one side, or an implant that has moved to an unnatural position. An in-depth evaluation will need to take place to determine the cause of the asymmetry and then a revision surgery would be performed to resolve the issue.  Finally, a new set of breast implants would be placed to achieve a balanced look.


This is a problem that can happen if one or both implants "bottom out" or drop too low. Sometimes, this is a placement issue from the original breast augmentation. To correct this, a different placement technique may be considered. For some patients, tissue grafting may be needed to reinforce the surgically created pocket to fit the new implant. 


Sometimes, breast revision surgery is as straightforward as getting a different sized breast implant. During the first surgery, you may have gone too big or too small. A different implant size can be placed to achieve the desired appearance.


This is scar tissue, occurring when the soft tissue that surrounds the implant becomes thick and hard. While most augmentations do create some internal scarring, most of the time this scarring is thin and soft. In some circumstances, the scar tissue becomes very hard and can alter the implant position, which may change the breast shape and result in an undesirable appearance. Partial or total capsulectomy surgery to remove this scarring may be necessary.


Implant rippling occurs when you see visible wrinkles and ripples under the skin. This deformity typically forms near the edge of the implant. Rippling is generally found in women who are very thin with saline implants. Many times, this issue can be corrected by simply switching to a silicone breast implant.


While this represents a small percentage of cases, breast implant rupture can occur. When a saline implant ruptures, the implant will usually deflate quickly. Because of this, visible flattening will be noticeable. Meanwhile, if a silicone implant ruptures, it is only detected via an MRI. Either way, when a rupture occurs, a replacement surgery or removal surgery will be necessary.


Symmastia occurs when breast implants are placed too closely together. Most often, this is because the breast implant chosen was the incorrect width, shape, or size. Breast revision surgery will repair this visible deformity by using an implant that works with your frame and may also require tissue or mesh reinforcement.  


Following your procedure and a brief observation period, you should be able to go home to begin your recovery. The recovery period varies, depending on what is involved in your surgery. A revision that needs any type of reconstruction or grafting will have a longer recovery, which could last up to 6 – 8 weeks. You should slowly start to see your results as the bruising and swelling begins to disappear. Dr. Couvillion will discuss what you can expect while you recover. You should also schedule your follow-up visits as often as directed so that Dr. Couvillion can monitor your healing and results.


How much does breast revision surgery cost?

Your cost for breast revision surgery will vary based on the complexity of your procedure. In your consultation, Dr. Couvillion will listen carefully to your needs and goals before completing a physical examination of your current implants. After this, he will discuss your choices before creating your treatment plan. The total cost of breast revision surgery will be based on the length and complexity of the procedure, plus your new implants. It's better to concentrate on getting great results by choosing a skilled plastic surgeon, like Dr. Couvillion, instead of the cheapest surgeon. As a way to help make your surgery affordable, SBA Dermatology accepts multiple payment types and we will give you information on low-interest medical financing.

Is breast implant removal surgery covered by insurance?

Some insurance companies will pay to remove breast implants in the setting of severe capsular contracture or failure of an implant.  Every company has a different policy regarding breast implant removal, and these are generally published online.  Your cost in the setting of an insurance-approved surgery will vary based on your specific policy. When you meet with Dr. Couvillion, he will help to create a treatment plan to achieve your goals.   

What if Dr. Couvillion wasn't my original surgeon?

Dr. Couvillion can perform your breast revision surgery even if he was not your original surgeon. Revision surgery is sometimes more difficult compared to augmentation surgery, especially if you want significant changes or have problems. This is why it is important to select a plastic surgeon, like Dr. Couvillion, who has advanced training and experience in breast surgery. Dr. Couvillion also encourages his patients to come back to SBA Dermatology for breast revision surgery after their original breast augmentation surgery if they notice an issue or would like new implants.

What about loose skin?

When you are getting your implants exchanged or removed, you may want to have excess skin removed as well. After hearing your goals and evaluating your current implants, Dr. Couvillion can discuss adding a breast lift to remove sagging skin.  

Will there be new scars?

Whenever possible, Dr. Couvillion will try to make incisions for breast revision surgery in the same place as your original augmentation incisions. If this isn't possible, he will place the revision incisions where they are least visible. Revision surgery may use a periareolar incision (along the lower border of the areola), an inframammary incision (beneath the breast fold) or an incision that is shaped like an anchor. Dr. Couvillion will explain scar care instructions so your new incisions heal flat and blend with your normal skin.

Do I have to change my implants?

Although implants are long-lasting, they may require replacement eventually. Once you've had breast augmentation, it's important to get your implants examined at least once a year so Dr. Couvillion can help you determine if your implants need to be exchanged. With frequent advances in implant technology, you may prefer a new implant type or shapes to get a better outcome from breast revision surgery.


Breast revision surgery is a specialized procedure tailored for your specific needs by talented plastic surgeon Dr. Ryan Couvillion. If you are not happy with your breast augmentation results or wish a different result, we invite you to call our Houston, TX office to schedule your appointment at SBA Dermatology. There are numerous factors to consider and Dr. Couvillion will give you a full physical exam, create your revision options, and discuss realistic expectations.

 When it comes to treating your skin, it's important to choose a specialist who knows the skin inside and out. To meet with one of our board-certified dermatologists or other experienced practitioners, call our office at 713-850-0240.