Breast Revision: Capsular Contracture & Lift, Istanbul

Patient Overview

• Patient: Deborah

• Age: 32 years old

• Gender: Female

• From: United States

• Procedures: Capsulectomy, Implant Removal, Implant Pocket Revision, New Implant Placement, Breast Lift (Mastopexy)

• After photos taken at: 6 days post-surgery

• Location: Istanbul, Turkey

Revision Breast Surgery in Istanbul: Correcting Capsular Contracture and Asymmetry

Deborah is a 32-year-old patient from the United States who came to Dr. Cem Berkay Sinaci in Istanbul for a complex revision breast surgery. She presented with a significant breast asymmetry caused by two very different problems on each side: a capsular contracture on one breast, which had made the implant hard, distorted, and unnaturally positioned, and a severely ptotic (sagging) breast on the other side, where the implant had become poorly positioned within a stretched, drooping breast envelope. The combined result was one of the most pronounced asymmetries seen in revision breast surgery.

Dr. CBS addressed both sides comprehensively in a single surgical session: capsule removal (capsulectomy), old implant removal, implant pocket revision, placement of new implants, and a breast lift (mastopexy) to correct the ptosis and reshape the breast envelope on the affected side. These before and after photos were taken just 6 days after surgery — an exceptionally early time point that already shows the correction of the asymmetry that had dominated Deborah's appearance for years.

What Is Capsular Contracture and Why Does It Happen?

Capsular contracture is the most common complication of breast augmentation surgery. After any breast implant is placed, the body forms a thin layer of scar tissue around it — this is a normal and expected response to a foreign material. In most patients, this capsule remains soft, thin, and completely undetectable. In some patients, however, the capsule thickens, hardens, and contracts around the implant, distorting its shape and position and causing firmness, discomfort, and visible breast deformity.

Capsular contracture is graded on the Baker scale from I to IV: Grade I is a soft, natural-feeling breast; Grade II involves mild firmness; Grade III presents visible distortion and firmness; and Grade IV is severe — with pain, significant hardness, and marked deformity. The causes are not fully understood but are associated with subclinical infection, biofilm formation around the implant, bleeding (hematoma), and certain implant characteristics. Regardless of cause, established capsular contracture — particularly at Grade III or IV — does not resolve without surgery.

Breast Asymmetry: Two Very Different Problems on Each Side

What made Deborah's case particularly complex was that the two sides presented with entirely different pathologies requiring different surgical solutions. On the capsular contracture side, the hardened capsule had to be fully removed (a complete capsulectomy) to eliminate the scar tissue entirely, followed by implant pocket revision to create a new, clean space before placing the new implant. Simply exchanging the implant without removing the thickened capsule has a high recurrence rate of contracture — a total capsulectomy is the most effective approach.

On the other side, the challenge was different: the breast had developed significant ptosis over time, with the breast tissue and skin envelope drooping well below the implant, creating a "waterfall" deformity where the implant sits high while the breast tissue descends beneath it. This degree of ptosis cannot be addressed by pocket revision or implant exchange alone — it requires a formal breast lift with implant, where the breast skin and glandular tissue are reshaped and elevated, the nipple is repositioned to the correct level, and the implant is re-seated within the corrected envelope.

The Surgical Plan: A Comprehensive Revision in One Session

Dr. CBS performed Deborah's full revision in a single surgical session — addressing both breasts simultaneously to ensure balanced, symmetric results. On the capsular contracture side: a complete capsulectomy was performed, removing the entire hardened capsule; the old implant was extracted; the pocket was carefully revised and prepared; and a new implant was placed into the clean, revised space. On the ptotic side: the old implant was removed; the pocket was reassessed and adjusted; a new implant was placed; and a mastopexy (breast lift) was performed over the new implant to lift the breast envelope, reshape the glandular tissue, and reposition the nipple to the correct height.

Performing a breast lift simultaneously with implant placement is one of the most technically demanding combinations in breast surgery. The skin excision and reshaping must account for the new volume provided by the implant, and the blood supply to the nipple-areola complex must be carefully preserved throughout. It requires precise planning and experience with both procedures to achieve a safe, symmetric, and aesthetically excellent result in a single operation.

Results at 6 Days: Already Showing the Correction

These photos were taken just 6 days after surgery — the earliest post-operative time point at which results are typically documented. At this stage, significant swelling, bruising, and initial healing are still very much present. The breast shape, softness, and final position will continue to evolve over the following 3 to 6 months as all swelling resolves, the implants settle, and the lift scars begin to mature and fade.

Despite the very early timing, the key result is already unmistakable: the severe asymmetry that Deborah had lived with for years has been corrected. Both breasts now sit at the same level, with matching implant position, comparable breast shape, and a symmetric nipple height. The capsular contracture has been eliminated on the affected side, and the ptotic breast has been lifted and reshaped to match. Seeing this correction even at day 6 — before the vast majority of swelling has resolved — underlines the extent of the problem that was present before surgery.

Who Is a Candidate for Revision Breast Surgery?

Revision breast surgery is appropriate for any patient experiencing dissatisfaction or complications following a previous breast augmentation — whether that is capsular contracture, implant malposition, rupture, asymmetry, or simply a change in the patient's aesthetic goals over time. Age is not a barrier: Deborah's case shows that revision surgery can be needed even in younger patients who had their original augmentation in their twenties.

The most important factor is choosing a surgeon with specific experience in revision breast surgery. Revision cases are significantly more complex than primary augmentation due to the altered tissue planes, the presence of scar tissue, and the need to often combine multiple techniques — capsulectomy, pocket revision, implant exchange, and lift — in a single session. For patients considering breast lift with implants as part of a revision, the surgical planning is especially critical.

Why Choose Istanbul for Breast Revision Surgery?

Istanbul has become a leading destination for complex breast revision surgery, offering access to highly experienced plastic surgeons, internationally accredited facilities, and comprehensive perioperative care — at a cost that is substantially lower than equivalent surgery in the United States. For American patients like Deborah, the combination of quality, expertise, and accessibility makes Istanbul an increasingly practical and attractive option for revision procedures that demand a high level of surgical skill.

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. He performs the full range of breast revision procedures — from capsulectomy and implant exchange to complex combined breast lift with implant revisions — with meticulous planning and technique. If you are experiencing capsular contracture, breast asymmetry, implant malposition, or any other concern following previous breast surgery, contact Dr. CBS to arrange a consultation.