Revision surgery corrects a problem with previous implants — contracture, malposition, a dropped fold or a change of size. Dr Thomas Colson treats grade III/IV capsular contracture with en-bloc capsulectomy, implant exchange and regenerative lipofilling, tailored to the specific problem.
Revision surgery addresses a problem with previous implants — hardening, malposition, a dropped fold, rippling, or a wish to change size. Dr Colson adapts the operation to the complexity of the specific problem rather than applying one routine.
For an established grade III–IV capsular contracture, he performs an en-bloc capsulectomy — removing implant and capsule together — usually with an implant exchange and regenerative lipofilling to restore soft-tissue cover and calm the pocket.
Implant malposition is corrected with scars placed according to areolar position. A dropped inframammary fold is rebuilt with capsulorrhaphy or, in selected cases, an abdominal advancement flap to re-establish a stable fold.
In line with UAE Department of Health guidelines on modesty and medical advertising, breast surgical results are not published online. Outcomes relevant to your own anatomy are reviewed privately during your consultation, alongside a Crisalix 3D simulation of your planned result.
If you are dealing with a specific problem, these guides explain it in detail: capsular contracture — a firm, hard or distorted breast after implants — and breast implant rupture, including the signs and what to do.
Revision surgery corrects a previous result, but it does not reset the clock. It is technically more demanding than a first augmentation, the tissues have already been operated on, and the original risks continue to apply. Dr Colson reviews the following with every patient before consent.
| Risk | What it means | How it is managed |
|---|---|---|
| Recurrence of capsular contracture | Contracture can return after treatment, and the risk of recurrence is higher in a breast that has already had one. | Capsulectomy rather than capsulotomy where appropriate, change of plane or implant surface, and long-term follow-up — see capsular contracture. |
| A more extensive dissection | Removing a capsule intact means working close to the chest wall and the rib cage. Bleeding risk is higher than at a first operation, and entry into the pleural cavity (pneumothorax) is a rare but recognised complication. | Capsule removal is tailored to what is clinically necessary rather than performed maximally by default. |
| Thin or damaged soft-tissue cover | After several operations the tissue over the implant can be thin, giving rippling, visible edges or poor shape. | Fat grafting is used to rebuild cover; a change of plane is sometimes proposed. |
| Explantation without replacement | If implants are removed and not replaced, the breast will be smaller and looser than before, and the skin may not retract fully. | A lift, fat grafting, or both can be combined; the likely appearance is discussed frankly beforehand. |
| Further surgery may still be needed | Revision reduces a problem; it does not guarantee that no further operation will ever be required. | Discussed as part of a long-term plan rather than as a one-off repair. |
| Sensation change, bleeding, infection, anaesthetic risk | As for any breast operation, and cumulative across repeated procedures. | Pre-operative assessment, sterile no-touch technique, early mobilisation. |
When a capsule is removed, it is sent for histological examination. This is how breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) — a rare lymphoma of the capsule, described mainly with textured implant surfaces — is identified. Any new, one-sided swelling or fluid collection around an implant should therefore be assessed rather than watched, and where it is present, fluid is sampled and analysed before surgery is planned. Diagnosed early and treated by complete removal of the implant and capsule, it is generally curable.
Under UAE Department of Health rules on health media and advertising, patient information must be balanced. None of the above is a reason to avoid surgery — it is the material on which an informed decision is made, and each point is discussed again, applied to your own anatomy, before you consent.
Consultations and surgery with Dr Thomas Colson are performed exclusively at Sheikh Khalifa Medical City (SKMC) in Abu Dhabi, within the SEHA network. A pre-operative Crisalix 3D simulation lets patients preview the planned breast shape before deciding.