Breast Implant Revision: Asymmetry Correction, Istanbul

Patient Overview

• Patient: Zuhal

• Age: 36 years old

• Gender: Female

• From: New York, USA (originally from Turkey)

• Procedures: Revision Breast Augmentation — Implant Removal, Pocket Revision (Submuscular to Dual Plane 3), New Implant Placement

• After photos taken at: 1 month post-surgery

• Location: Istanbul, Turkey

Revision Breast Augmentation in Istanbul: Correcting Implant Asymmetry

Zuhal is a 36-year-old patient originally from Turkey, living in New York, USA. She returned to Istanbul to undergo revision breast augmentation surgery with Dr. Cem Berkay Sinaci after experiencing a significant breast asymmetry caused by a poorly positioned implant from a previous surgery. One of her implants had been placed too high and positioned entirely beneath the pectoral muscle — a placement known as total submuscular — which caused it to sit unnaturally high on the chest wall and created a visible, distressing asymmetry between the two breasts.

Revision breast surgery is one of the most complex areas in aesthetic plastic surgery, requiring detailed preoperative assessment, precise surgical planning, and experience with the full range of implant pocket techniques. Dr. CBS performed a complete revision: removing both implants, correcting the malpositioned pocket, and placing new, larger implants in a dual plane 3 position — fully resolving the asymmetry and achieving the fuller, more balanced result Zuhal had always wanted.

What Is a High-Riding Implant and Why Does It Happen?

A high-riding implant — also called implant malposition or superior displacement — occurs when a breast implant sits too high on the chest wall, above the natural breast fold or inframammary crease. This is one of the most common complications following breast augmentation surgery and can result from incorrect pocket dissection, failure to adequately release the lower pole of the breast, excessive pectoral muscle tension pulling the implant upward, or simply incorrect surgical planning.

In Zuhal's case, the implant had been placed in a fully submuscular position — meaning the entire implant was covered and held by the pectoral muscle. While this plane was once routinely used in breast augmentation, it is now understood to be problematic in many patients: the strong, dynamic pectoral muscle can push the implant upward over time, creating an unnatural high position and — as in Zuhal's case — significant asymmetry. A high-riding implant does not resolve on its own and requires surgical correction.

Total Submuscular vs. Dual Plane: Understanding the Implant Pocket

The implant pocket — the space created to hold the breast implant — is one of the most important decisions in breast augmentation surgery and one of the most common sources of unsatisfactory results when chosen incorrectly.

In a total submuscular placement, the implant is completely covered by the pectoral muscle. This often leads to animation deformity, high implant position, and limited lower pole fill. The dual plane technique solves many of these problems by partially releasing the lower portion of the pectoral muscle, allowing the implant to sit in a more natural position. In a Dual Plane 3 — the most extensive dual plane release — a greater portion of the muscle is released, allowing the implant to descend into the lower pole and create a fuller, more natural breast shape. This is particularly effective in revision cases where the implant needs to be repositioned downward.

The Revision Surgery: Pocket Correction and New Implant Placement

Dr. CBS began by removing both implants to allow complete access to the pockets and a full assessment of the tissue. On the affected side, the pocket was carefully revised from total submuscular to dual plane 3: the inferior origin of the pectoral muscle was released to allow the implant to descend to the correct position on the chest wall, aligning with the inframammary fold and matching the natural breast position on the other side.

Precise pocket revision is the most technically demanding aspect of revision breast surgery. The goal is not simply to move the implant down, but to reshape the entire pocket so that the implant is contained correctly and supported from below — preventing migration back upward over time. Internal sutures were used where necessary to reinforce the new pocket boundaries and ensure stable, lasting positioning. Both sides were reassessed and balanced before the new implants were placed, ensuring symmetry in projection, footprint, and lower pole fill.

Larger Implants: Achieving the Volume Zuhal Wanted

As part of the revision, Zuhal chose to increase her implant size — a common decision in revision surgery. The new implants were selected to complement the corrected dual plane 3 pocket, ensuring the larger volume would be appropriately supported and distributed across the lower pole for a natural, proportionate result.

Implant selection in revision cases requires careful consideration of the existing tissue, skin envelope, and the revised pocket dimensions. Dr. CBS assessed the base width, projection, and volume to select implants that would fill the new pocket correctly and deliver the fuller, symmetrical outcome Zuhal was looking for.

Results at 1 Month: Symmetry Restored

These before and after photos were taken 1 month after surgery. There is still residual swelling at this stage and the implants have not yet fully settled — a process called dropping and fluffing that continues over 3 to 6 months. Despite this, the correction of the asymmetry is already clearly visible: both implants now sit at the same level, the previously high-riding implant has been repositioned to match its counterpart, and the overall breast shape and volume are significantly improved.

Full results will be visible by the 3 to 6 month mark, when the implants have settled completely and all swelling has resolved.

Why Choose Istanbul for Revision Breast Augmentation?

Istanbul has become one of the world's leading destinations for breast revision surgery, attracting patients from across the USA, Europe, and the Middle East who seek experienced surgeons, internationally accredited facilities, and outcomes that meet the highest aesthetic standards — at a significantly lower cost than equivalent surgery in the United States or Western Europe.

Dr. Cem Berkay Sinaci is a European and Turkish board-certified plastic surgeon, Fellow of the European Board of Plastic Reconstructive and Aesthetic Surgery (EBOPRAS), and member of ISAPS and ASPS. With extensive experience in both primary and revision breast surgery, Dr. CBS offers patients thorough preoperative assessment, detailed surgical planning, and meticulous technique to achieve natural, lasting, and symmetrical results. If you are considering revision breast augmentation, implant replacement, or correction of implant asymmetry, contact Dr. CBS to arrange a consultation.