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Preoperatively, the breast implants were located in a subpectoral pocket in 78.7% of the patients and, postoperatively, in a subglandular pocket in 74.8% of the patients. Within the first 2 years, 13 patients (8.7%) underwent reoperation for additional fat grafting. Among 45 preoperative breast capsular contractures, there were eight recurrences in the first 3 years and four reoperations. CONCLUSIONS Secondary breast augmentation cannot rely solely on implant exchange. Because the soft-tissue envelope also ages over time, fat grafting

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