Secondary Breast Augmentation: Is There a Trend for Bigger Implants?



Despite novel assessment tools and 3D simulation, patient’s desire for implant size change is one of the most common reasons for revision surgery after primary breast augmentation. In this study, we analysed outcomes and predictive indicators for revision surgeries in a cohort of patients operated on by a single surgeon.

Patients and Methods

All consecutive patients who underwent revision augmentation surgery between 2013 and 2017 by the first author were included in this study. Besides review of medical records, subgroups based on the indication for revision surgery were compared and statistically analysed.


A total of 110 patients were included in this study. Revision surgery was performed 97.2 months on average after primary augmentation. Eighty-six per cent of patients received larger implants. Indications for revision surgery and associated subgroups were: (1) wish for bigger implants (38%), (2) complication + wish for bigger implants (26%), (3) complication (29%), (4) complication + wish for smaller implants (3%) and (5) wish for smaller implants (3%). Subgroup analysis showed that patients who underwent revision surgery for bigger implants were significantly younger compared to patients who suffered a complication or desired smaller implants. Time to secondary augmentation was significantly shorter in case of wish for size change compared to complications as reason for revision surgery. Implant sizes differed significantly in patients where volume change was the sole indication for surgery compared to revisions performed due to complications.


In our cohort of patients, almost all patients who underwent revision surgery after primary breast augmentation received bigger implants. Patients who specifically wished for size change were younger, asked for surgery earlier and received larger volumes compared to patients who underwent revision surgery for other reasons.

Level of Evidence IV

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Correspondence to Paolo Montemurro.

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Conflict of interest

Dr. Montemurro is a consultant and speaker for Allergan, Inc. (Irvine, Calif.). Dr. Fischer has no disclosures. Dr. Hager has no disclosures. Dr. Hedén is a consultant and speaker for Allergan, Inc. (Irvine, Calif.) and an unpaid consultant for Canfield Scientific (Fairfield, N.J.).

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Montemurro, P., Fischer, S., Hager, S. et al. Secondary Breast Augmentation: Is There a Trend for Bigger Implants?. Aesth Plast Surg 43, 59–69 (2019).

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  • Breast augmentation
  • Breast implantation
  • Secondary breast augmentation
  • Complications