Breast implant revision surgeries for aesthetic concerns and complications like capsular contracture have steadily increased from 2022 to 2024.
Courtesy of nenetus at Adobe Stock
October is Breast Cancer Awareness Month, and in recognition of the 1 in 8 women who will be diagnosed with breast cancer in their lifetime [1], the non-profit Aesthetic Foundation has composed its first annual ARISE report—the American Registry for Breast Implant Surveillance and Evaluation. The report suggests that the number of breast implant requests has increased, but patients are increasingly circling back for revisions due to aesthetic concerns, capsular contracture and implant complications.
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October is Breast Cancer Awareness Month, and in recognition of the 1 in 8 women who will be diagnosed with breast cancer in their lifetime [1], the non-profit Aesthetic Foundation has composed its first annual ARISE report—the American Registry for Breast Implant Surveillance and Evaluation. The report suggests that the number of breast implant requests has increased, but patients are increasingly circling back for revisions due to aesthetic concerns, capsular contracture and implant complications.
About 11 clinicians on the comittee oversaw the report—a cumulation of data collected over four years, starting in 2021 when the ARISE U.S. Registry launched on the Aesthetic One platform. The STAR study, part of the ARISE registry, is a clinical study in the U.S. to prospectively collect data on patients undergoing breast augmentation surgery. Enrolling 1,000 patients, STAR collected breast data pre-operatively and for two years post-operatively, leading to the publishing of trends and outcomes related to breast implants through September 2025.
Once a leading cause of complications in reconstruction, capsular contracture dropped to 0% by 2024—while rising in augmentation cases.Courtesy of Vadim at Adobe StockWith over 120,000 devices registered within the ARISE registry, representing implants from five leading manufacturers in the U.S., the report includes device data and procedural trends from five distinct cohorts: breast augmentation, revision breast augmentation, breast reconstruction, revision breast reconstruction and implant removal without replacement, per an Oct. 1 press release.
Looking at procedure type between 2022 and 2024, revisions for primary augmentation have increased steadily by about 4%, starting at 11.4% in 2022 and moving up to 15.8% in 2024 [2]. While revisions for the procedure go up, requests for primary augmentation procedures in general have decreased by over 6%.
Requests for primary reconstruction, on the other hand, have remained somewhat steadfast, with little fluctuation. Revisions, however, did increase subtly here, too, as well. In 2022, revisions for primary reconstruction stood at 0%, but by 2024, revisions increased by 1.4%.
The reason for revisions are predominately attributed to purely “aesthetic” reasons among both procedures, but throughout the years, capsular contracture and deflation, or rupture, become apparent variables for augmentation revisions in particular. The percentage of revisions with the reasoning being capsular contracture jumped to 12.1% in 2024.
As mentioned earlier, the reasons for reconstruction revisions, the report outlines, is also predominately for aesthetic reasons, but when it comes to capsular contracture, the reason diminishes from the equation completely by 2024. In 2022, the percentage of capsular contracture complications were 14.2%--higher than its reasoning for augmentation—and by 2024 it was 0%.
This begs the question, why is scar tissue tightening and hardening for augmentations increasing more, whereas it grows out of being a factor altogether for reconstruction by 2024?
Fat grafting and its implication on reconstruction could explain the reason behind why capsular contracture, commonly found when using implants, is seeing its way out as a factor. The body reacts to implants in this way because detects foreign objects and attempts to isolate the object by creating a barrier of scar tissue around it [3].
Fat grafting, once mainly used to fix contour issues during revision surgeries, is now also used to shape and size the breast—either alongside other reconstruction methods or on its own for full breast reconstruction [4]. The Aspire Report shows that the use of autologous fat transfer at time of implantation saw an increase in use, up by 0.6% by 2024 [2].
