11 September 2026 | 7 minute read
Whether you’re quietly contemplating a subtle refresh or actively researching a life-changing procedure, navigating the world of aesthetic surgery can feel overwhelmingly noisy. Cutting through that clutter requires a voice grounded in exceptional skill, unwavering medical ethics, and genuine empathy.
Enter Ms Nora Nugent—one of the UK’s most distinguished Consultant Plastic Surgeons.
As President of the British Association of Aesthetic Plastic Surgeons (BAAPS) and President of the European Society for Aesthetic Plastic Surgery (ESAPS), Ms Nugent doesn’t just practise at the absolute pinnacle of her field; she actively sets the standard for it. With a decade of dedicated NHS consultancy at the world-renowned Queen Victoria Hospital, her clinical expertise ranges from delicate, natural-looking facial rejuvenations to complex reconstructive procedures.
Based at her Tunbridge Wells clinic, Purity Bridge, and Harley Street, she brings a uniquely refined, patient-centred approach to modern cosmetic surgery. In a realm where precision meets artistry, Ms Nora Nugent stands out as a true master of her craft—and a trusted guide for anyone looking to feel entirely confident in their own skin.
Frequently Asked Questions About Breast Revision
What are the first things you assess when someone comes to you for breast revision after being unhappy with a previous operation?
Key points include delving into why someone is unhappy with the previous surgery: What specifically are they unhappy about? Was it a complication early in the recovery, or has it happened gradually over several years? Is the implant the problem? Or is it breast shape or size over the implant? Or a combination of both? Next, I ask about the goals of revision surgery if they aren’t clear from the previous points. Then I ask about the previous surgery – what was done, where implants were placed, and any general health issues. After that, there is the physical exam to assess both breasts and implants and a discussion about treatment options.
Which breast implant problems can usually be corrected with breast implant revision surgery, and which tend to be more challenging to improve?
Usually, revision surgery can correct moderate size issues, implant position problems, capsular contracture, implant ruptures, and breast sagging. Problems that are more difficult to treat (but not impossible) are very thin, stretched skin and breast tissue (we can tighten, lift, and reposition, but the quality of the skin cannot be completely corrected or requires additional multistage treatments, such as fat transfer or IPL/laser), downsizing excessively large implants, recurrent capsular contracture, and badly scarred breasts after bad infections or tissue loss.
How does previous surgery, such as scar tissue, stretched skin, or changes to the implant pocket, affect the options available during a revision?
I do a lot of secondary breast implant and revision surgery, so I am very used to navigating scar tissue, stretched skin, overlarge implant pockets, and more. It does make secondary surgery more complex than first-time breast augmentation surgery. Mild to moderate cases are usually manageable. If on the more severe end, then careful planning and sometimes staged procedures or agreeing on what’s achievable rather than the ideal goal for surgery will be needed.
When treating capsular contracture, what determines whether the capsule needs to be partially treated or completely removed?
Usually, if capsular contracture is present, I aim to remove the entire capsule rather than partially remove it. The two main circumstances where I would switch to partial removal are when the overlying breast and skin are very thin and removing the entire capsule may damage them or substantially increase the risk of tissue loss, and when the implant pocket (and capsule) is partially under the muscle. The back wall of the capsule overlying ribs is very adherent and risks damaging the underlying tissue, including causing a pneumothorax (perforation of the lining of the lung). In these situations, it is safer to retain some capsule than to cause excess tissue trauma and damage.
If a patient wants to change the size or type of her implants during revision, what factors help you decide what will work safely with her existing breast tissues?
I always try to work towards a proportional size that my patient’s breast tissue can support–a shape that fits her aesthetic goals and her breast shape, and a plan that will have good longevity. I look at overall body proportions, breast base measurements, breast volume, and tissue quality and combine that with the patient’s aesthetic goals. If I do not think the type or size of implant desired will last well or give a good breast appearance, I will always be honest about this during the pre-surgery consultation.
How do you approach breast asymmetry during revision when some of the difference comes from the patient’s natural anatomy rather than the implants themselves?
It is very important to analyse the breast fully before a secondary breast augmentation. I access chest and breast asymmetry, as well as implant asymmetry. I also access asymmetry caused by previous surgery versus the patient’s natural anatomy. Some aspects of asymmetry can be improved but not completely corrected, and some are easier to correct than others. A full preoperative analysis of every component helps me plan properly. If there is a size difference, I also look to see if I can use similar implants and adjust breast tissue to similar amounts. A similar ratio of breast to implant tissue on each side usually means the breasts look, feel, and age similarly, compared to one breast being large with a small or no implant and the other being small with a large implant.
When an implant has dropped, shifted sideways, or is sitting too high, what needs to be corrected internally to create a more stable result?
The breast implant pocket needs to be reshaped and closed off. If needed, the opposite side of the pocket is released to allow the implant to sit in the right place. Sometimes creating a new pocket, like moving implants from under to over the muscle or vice versa, is the best plan. Some implants hold their position better than others, so a different type of implant may help. Sometimes tissue reinforcement with internal sutures or a mesh/scaffold is also needed.
When might breast revision surgery involve more than replacing the implants, such as combining surgery with a breast lift or fat transfer?
This is very common and is probably needed in 60% to 70% of breast revision surgeries that I do, particularly if implants have been in place a long time and there has been significant breast ageing, as well as if pregnancy/breastfeeding changes have occurred. Thin skin/breast tissue and sagging breast tissue are the most common reasons.
Are there circumstances where removing the implants and allowing the breast to heal before performing further breast surgery gives a better or safer result?
Yes, severe recurrent capsular contractures, badly scarred, or infected breasts can sometimes benefit from an “implant holiday” to allow the breast tissue to recover from trauma and/or repeated previous surgeries. Difficult shape conditions may also benefit from allowing the breast to recover so you can see its true shape before planning the best implant replacement.
What should patients understand about the limitations of breast revision procedures, particularly after several previous breast operations?
Patients must understand that revision or secondary breast surgery is almost always more complex, longer, and more expensive than first-time breast augmentation. An implant in place for some time changes the breast tissue (stretch/weight), and breast ageing and/or hormonal and weight changes will also have occurred. More extensive surgery also means a different recovery and healing process, and it may not be possible to replicate the early results of the first surgery or to achieve very full or large breasts.
Schedule Your Breast Revision in Tunbridge Wells
To schedule your private consultation with Ms Nugent in Tunbridge Wells or Harley Street, London, please call 44 (0) 1892 619248 or use our online contact form.