Women who are unhappy with the results of their original breast implant surgery may wish to consider an alternative approach to breast implant revision using the safer polyurethane-covered silicone breast implants.
As there are many thousands (in fact hundreds of thousands) of women in Australia with breast implants, there is a high demand for revision surgery for occasional problems with breast implants. With current implant technology, especially with the polyurethane (P-URE) implants, the operation is safe and the majority of patients have a quick recovery with few problems. However, problems can arise and if they do we have an approach to managing them.
Benefits of breast implant revision with Dr. David:
  • Experienced surgeon who has successfully performed thousands of cosmetic breast operations
  • Safety and superior results with the use of polyurethane-covered implants
  • Possible correction of several problems that often occur with standard implants
  • All-inclusive surgery and recovery packages for $12, 900
  • Medicare and Private Health Insurance rebates may apply


Dr David Topchian treats patients who have had surgery elsewhere and have been dissatisfied with the results. Each patient’s concerns are addressed specifically, and a range of options for treatment are provided, with expected success of each explained. The surgical plan is tailored to each patient’s circumstances.
The typical types of problems that women can experience, in approximate order of likelihood, are:



This is when the implant(s) harden, feeling more like a tennis ball and sometimes distorting the breast into a round shape. It can also be painful or uncomfortable for the woman. The treatment is to replace the encapsulated implant and sometimes remove the old capsule, with a new space created for the new implants.
Round Implants: Previously, round implants (implants that appear symmetrical when viewed from the side) were the most popular type. Although round implants are still appropriate for some women, they do produce slightly more fullness in the upper part of the breast. This results in a ’rounder’ look that some women prefer to avoid.
Teardrop Implants: Teardrop implants aren’t actually teardrop in shape, but they are a more natural breast shape when viewed from the side, with less fullness at the top part of the implant. Sometimes they are called anatomical implants, because they look more like a natural breast.
This type of implant can be of benefit to women who have some degree of sag or have a difficult breast shape to begin with. A further benefit of using teardrop implants is that the width of the implant can be different to the height of the implant. This enables a closer match to the base of the existing breast, with an improvement in cleavage or reduction in upper breast bulging.


If the implants move from their intended position (usually to one or other side, or down) then the appearance of the breast or breasts can be unattractive. Standard implants do not adhere to the tissues, and, especially over time can stretch the breast tissues down with the force of gravity, making the breast look saggy.
Treatment would usually involve replacing the implants with P-URE implants and allowing 4 weeks for the integration of the P-URE foam with the tissues.



The largest concern that women considering implants for the first time have is that they will choose the wrong size – either too small or too large.
Women who have never had larger breasts (for example their breasts have never developed) often find it hard to imagine what larger breasts will look and feel like.
For those women who have had the experience of larger breasts but now find them smaller following having children, weight loss, or normal ageing, do have a better idea of what they would like in terms of final breast size and are often more confident in their selection of an implant at the sizing stage of their consultation.
It is relatively straight-forward to replace the existing (too large or too small) implants, although consideration should be given to skin stretching or retraction and where the nipple will be located with the new implants.


Optimal results in breast implant surgery are obtained when the correct implant is placed in the correct plane (under or over muscle) via the correct incision (we recommend a breast-crease incision for most women).
The reasons for some surgeons choosing to go under the muscle are often historical – they use the same technique they learnt 30 years and don’t see a reason to evolve with the newer implant technologies. In using P-URE implants we can often correct old-style problems with less invasive surgery and obtain a good result for our patient.


A difference between the two sides of the body is normal and natural, and this is especially true of the breasts. Sometimes one side is larger or in a different position to the other breast, so surgery to correct this usually involved just the one breast but can involve improving both breasts.


This is when the waviness of the implant edge is visible on the skin, or can be felt when touching the breast. It is usually experienced in thin women or those who have lost weight and have a thin layer of tissue over the implants that does not adequately disguise the implant edge.
Treatment can vary between changing the position of the implant to changing the implant itself.


When implant are placed under the muscle, as they often are with saline implants (see below), the breast can move in a odd, un-natural way when the pectoralis muscle is contracted.
The only way to address this is to place the implants on top of the muscle, however this can be a potential problem for women with thin tissues in this area as they implant edge or rippling can be seen or felt (see above).


This problem only occurs with saline implants, when the outer (silicon) shell develops a small tear over time – typically 10-15 years – and the water inside leaks out and is harmlessly absorbed by the body. The implants can be removed or replaced with silicon implants that cannot deflate.



Sometimes an implant can develop a small tear in its outer shell and the silicon gel (in modern implants) can bulge out. This can produce a lump at the spot but is not dangerous.
Although we believe the bulging silicon is not harmful to health, the current recommendation is to replace that ruptured implant at some stage. There is no major urgency in most cases.


This is a rare complication (should be less than 1% in a high standard facility) and may require removal of the implant(s) for 3 months until the tissues heal, and then can usually be replaced. Sometimes specific antibiotics are taken for weeks or months to combat the bug that is causing the problem.
Difficulties arise sometimes when patients have surgery overseas (particularly in Asian countries) and return to Australia with a difficult to diagnose, or difficult to treat bug as these can be resistant to most regular antibiotics. This patient’s right breast is swollen following implants overseas. She is shown 3 months after implant removal and a breast lift.


Rarely the scars are too large or in the wrong position and scar revision can be performed to try and make the scars flatter/thinner/paler. Various lasers can be used in conjunction to achieve an optimal result.
In general, however, the breast skin and tissues heal well and scarring is always slightly visible but should not be too prominent.


As the body ages, the skin and tissues relax and allow the descent of breast tissue. When breast implants are under the muscle they adhere to the ribs and chest wall, meaning that they do not descent to the same extent as the breast tissue. This can result in a characteristic ‘Snoopy Nose’ deformity where the nipple appears too low and there is too much fullness at the upper part of the breast.
It is thought that the P-URE implants will descend less over time as they integrate with the tissues and support the breast tissue better.


If you are considering breast implant revision, you can book in for a Complimentary Consultaion with Dr David Topchian. During your consultation, you'll be able to get your questions answered, have a thorough professional examination to assess suitability, as well as more information to read at your leisure.

Dr David Topchian
See Dr David Topchian’s before and after breast implant case studies.


Opening hours:
Monday–Friday: 9:00am – 5:00pm
1800 745 536
Free basement parking with discrete lift access is available for clients during consultations.
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