Approaching Breast Implant Removal or Exchange: What Are Your Options?

As a board-certified plastic surgeon, I frequently meet patients who are considering breast implant removal or exchange for a variety of reasons. Whether it’s due to changes in personal preference, complications, or simply the desire for an update after years of having implants, it’s important to know that there are multiple options available when addressing breast implant concerns.

During a consultation, my goal is to provide personalized guidance and help patients understand the best course of action for their unique circumstances. In this blog, I’ll explain the various options available when it comes to breast implant removal or exchange, so you can feel informed and confident about your decision. Ultimately, it’s important to know that breast implant are NOT “lifetime devices,” they are designed and recommended to be removed anywhere from 10-20 years after placement, based on appearance, symptoms, and patient goals.

1. Breast Implant Removal (Explantation)

Some patients opt to have their implants removed completely without replacing them. This may be due to complications such as capsular contracture, implant rupture, or personal reasons like wanting a more natural look or lifestyle change.

What’s involved?

• Procedure: The surgeon makes incisions, removes the implants, and often removes the scar tissue capsule surrounding them, especially if capsular contracture or implant rupture is present. In some cases, patients also benefit from a breast lift (mastopexy) to address any excess skin and sagging after implant removal.
• Recovery: The recovery from implant removal is generally faster than an initial augmentation, but it can vary depending on whether a breast lift or other reconstructive techniques are needed. Swelling and bruising are common, but most patients return to normal activities within a few weeks.

Ideal for:

• Patients who want to return to their natural breast size and shape.
• Those experiencing complications such as implant rupture, capsular contracture, or other health concerns.

2. Breast Implant Removal and Replacement (Exchange)

For patients who want to maintain or change their breast shape and size but are dealing with implant complications or simply want an update, an implant exchange may be the best option. This procedure removes the current implants and replaces them with new ones, often of a different size, shape, or material.

What’s involved?

• Procedure: The old implants are removed, and new ones are inserted through the same or slightly modified incisions. You and your surgeon can decide on the new implant type—whether cohesive silicone gel, saline,—depending on your goals.
• Recovery: Recovery is typically similar to the initial augmentation, but in some cases, it may be faster, especially if the scar tissue is minimal and there are no major complications.

Ideal for:

• Patients who want a different look or feel, such as going larger or smaller in size, or switching to a different implant type.
• Those experiencing implant rupture, rippling, or dissatisfaction with their current implants.

3. Breast Implant Exchange with Lift (Mastopexy)

Over time, some patients not only wish to exchange their implants but also need a breast lift due to sagging or changes in skin elasticity. This combination approach, known as an implant exchange with a breast lift, can rejuvenate the appearance of the breasts by addressing both volume and shape.

What’s involved?

• Procedure: In addition to removing the old implants and inserting new ones, the surgeon performs a mastopexy to remove excess skin and reposition the breast tissue for a more lifted and youthful contour. The nipples may also be repositioned if they have shifted downward over time.
• Recovery: Recovery can be slightly longer than a simple implant exchange due to the lift procedure, but it’s generally well-tolerated. Most patients can return to work within a few weeks, although exercise and heavy lifting may be restricted for 4-6 weeks.

Ideal for:

• Patients experiencing sagging or drooping of the breasts, particularly after pregnancy, breastfeeding, or significant weight loss.
• Those seeking both an aesthetic improvement in breast shape and a change in implant size or type.

4. Breast Implant Removal with Fat Grafting (Autologous Fat Transfer)

For patients who wish to remove their implants but still want to retain some volume and shape, fat grafting can be an excellent option. Fat is harvested from other areas of the body, such as the abdomen or thighs, and transferred to the breasts to provide natural volume and contour.

What’s involved?

• Procedure: First, liposuction is performed to harvest fat cells from areas with excess fat. The fat is then purified and carefully injected into the breasts to restore some of the volume lost after implant removal. Fat grafting can be done alone or in combination with a breast lift for optimal results.
• Recovery: Recovery from fat grafting includes both the healing of the liposuction areas and the breasts. Swelling in the breasts and donor areas is common, and the final results may take a few months to fully settle.

Ideal for:

• Patients who want to avoid synthetic implants but still desire some volume in their breasts after explantation.
• Those who prefer a natural alternative with the added benefit of body contouring from liposuction.

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Final Thoughts

Deciding to undergo breast implant removal or exchange is a highly personal choice, and there’s no one-size-fits-all solution. Each patient has unique goals and concerns, whether it’s to restore natural breast aesthetics, resolve implant-related complications, or achieve a refreshed look.

During a consultation, I’ll work closely with you to understand your needs and recommend the best option, whether it’s a straightforward implant removal, an exchange, a lift, or fat grafting. My goal is to ensure you feel empowered and informed every step of the way, so we can achieve results that leave you feeling confident and satisfied with your body. If you’re considering a breast implant removal or exchange and would like to explore your options, I invite you to schedule a consultation where we can discuss your goals and develop a plan tailored to your individual needs.