Implant Exchange
Body area: breast
Overview
Implant exchange involves removing existing breast implants and replacing them with new ones. This may be performed for aesthetic reasons (desire for a different size, shape, or type), to address complications (capsular contracture, rupture, malposition), or as part of routine long-term implant maintenance.
Who is it for?
Patients with existing breast implants who need replacement due to complications, desire a change in size or type, or are performing routine implant maintenance.
Technique overview
The surgeon removes the existing implants, evaluates the capsule (scar tissue around the implant), and either places new implants in the same or modified pocket. Capsulectomy (removal of the capsule) may be performed if there is significant capsular contracture.
What this procedure cannot do
Implant exchange addresses the implant itself but cannot completely undo all changes that have occurred over the years — stretched skin, breast tissue thinning, or a position change of the inframammary fold may need additional procedures (mastopexy, capsulorrhaphy) to correct. Capsulectomy (full removal of the scar capsule, including 'en bloc' removal) is sometimes requested by patients with concerns about breast implant illness (BII); the science is evolving and the procedure is more complex than simple implant exchange. Patients seeking implant removal without replacement (explant) often need a lift or fat transfer to address the deflated appearance left behind.
Scars and incisions
Most implant exchanges use the existing scar — typically the inframammary fold or periareolar incision from the original surgery. Existing scars may be excised and re-closed, sometimes producing a slightly improved final scar. Capsulectomy may require a longer incision than a simple exchange.
Recovery
Recovery is typically similar to or faster than the original augmentation. Most patients return to normal activities within 1 to 2 weeks.
Longevity of results
New implants restart the long-term clock — they may last many years before any further intervention is needed, but they remain non-lifetime devices and another exchange or removal is possible later in life. Capsular contracture can recur even with new implants, especially in patients who have had it before. Site (pocket) modification, surface change, or other technical adjustments at the time of exchange can sometimes reduce recurrence risk.
Typical price range
$5,000 - $14,000
Common goals
- Replace aging or compromised implants
- Change implant size, shape, or type
- Address capsular contracture
- Correct implant malposition
- Routine long-term maintenance
Risks
- Capsular contracture recurrence
- Implant malposition
- Infection
- Changes in breast shape
- Asymmetry
How to choose a surgeon
Choose a surgeon board-certified by the ABPS who performs revision breast surgery regularly — implant exchange is more variable and judgment-dependent than primary augmentation. Ask how they decide whether to leave the existing capsule, perform partial capsulectomy, or do total/en bloc capsulectomy, what their experience is with patients seeking explant for BII concerns, and how they manage the soft-tissue envelope (lift, fat transfer) when implants are removed without replacement. Verify accredited facility and board-certified anesthesia.
Frequently asked questions
Should I have my old capsule removed?
It depends on the situation. For routine size or shape changes with a healthy capsule, leaving the capsule alone is often appropriate. For capsular contracture, ruptured implants (especially older silicone), or patient concern about breast implant illness, capsulectomy (partial, total, or en bloc) is often recommended. Each approach has trade-offs in risk and recovery; your surgeon should explain which is right for your case.
What is 'en bloc' capsulectomy and do I need it?
En bloc capsulectomy removes the capsule and implant as one intact specimen — this is most clearly indicated for confirmed or suspected BIA-ALCL (a rare cancer of the capsule). For other situations (BII concerns, routine exchange), the data on whether en bloc specifically is required versus thorough total capsulectomy is mixed. The procedure is more invasive than simple exchange. Discuss the rationale, risks, and your specific situation with a surgeon experienced in this area.
Can I just have my implants removed without replacement?
Yes — explantation is a valid choice for patients who no longer want implants. The aesthetic outcome depends on how much breast tissue you have, how stretched the skin envelope is, and how long the implants were in place. Many patients need a concurrent or staged lift, sometimes with fat transfer, to address the deflated appearance. Honest discussion of expectations is essential.
Will insurance cover any of this?
Insurance generally does not cover cosmetic implant exchange. It may cover removal in specific situations: confirmed or suspected BIA-ALCL, ruptured implants, or specific symptomatic capsular contracture, depending on the plan. Documentation of medical necessity is required. The cosmetic portion (size change, lift) remains out of pocket.
Editorial disclaimer: This page is educational content reviewed by the MDcontour editorial team. It is not medical advice, diagnosis, or treatment, and it does not establish a doctor–patient relationship. Always consult a board-certified plastic surgeon about your individual situation.