Breast Implant Replacement

Breast implant replacement is exactly what the name suggests: the existing implants are removed and new implants are placed in the same operation. It’s one type of revision surgery and is sometimes performed alongside other procedures, including a breast lift or fat transfer, to address changes in the breast that have occurred during the years the original implants have been in place.

Replacement is one of the most common reasons patients return for further breast surgery, and it can be driven by a clinical need (such as implant rupture or capsular contracture) or by a personal decision to change implant size or type or to refresh ageing implants. The right approach depends on why replacement is being considered, what’s happened to the breast tissue around the implants, and what the patient is hoping to achieve from the surgery.

Common reasons for considering implant replacement include:

No. Breast implants aren’t designed to last a lifetime, and patients who have implants placed should understand this from the outset. The length of time an implant remains in place varies, and there’s no fixed date at which all implants need to be replaced. Some implants are replaced after a relatively short time because of complications such as rupture or capsular contracture. Others remain in place for many years without any obvious problem.

We recommend long-term follow-up of breast implants for everyone, not just patients who have had a problem. Routine review at intervals, often combined with imaging where appropriate, allows changes to be picked up before they cause symptoms and gives the patient and surgeon a chance to discuss whether and when replacement should be considered.

Replacement typically means removing the existing implants, addressing the capsule of scar tissue around them where appropriate, and placing new implants. The capsule may be left in place, partially removed, or completely removed depending on its condition and the reason for the surgery. Decisions about the capsule are made on an individual basis, and the rationale is explained at consultation.

Replacement is often combined with adjustments to the pocket the implant sits in, particularly when there has been malposition, contracture, or change in the breast tissue around the original implant. A breast lift, fat transfer, or other adjunctive procedures may be performed at the same time, depending on what’s needed to produce a good result with the new implants in place.

We’ll ask about the history of your previous surgery, including the type of implants, the surgical approach used, the placement chosen, and any complications that have emerged since. Where possible, please bring records from your previous surgery, including the implant card showing the implant make, model and size. This information helps with planning and reduces the chance of unexpected findings during surgery.

Imaging may be requested to support the assessment, including ultrasound or MRI to assess the existing implants, particularly to check for rupture which can be silent in some implants. Going into surgery with as much information as possible about the existing implants makes the procedure more predictable and reduces the chance of decisions having to be made on the operating table.

Dr Shepherd uses silicone gel implants. The new implant is chosen together with you at consultation, weighing your anatomy, the previous implant, what’s changed since the original surgery, your goals, and any specific concerns about implant type. Implants vary in shape, surface texture, profile, base diameter and total volume, and choosing the right combination is a joint decision based on careful measurements and discussion.

Where the previous implants were of a type now associated with specific recognised risks, we’ll discuss that openly as part of the conversation about replacement. The discussion includes whether to use the same type of implant or a different one, and the reasoning behind the recommendation.

Implant replacement is performed under general anaesthesia in an accredited hospital. Operating time is usually between one and three hours, depending on the complexity of the replacement and any combined procedures. Most patients stay in hospital for one night and are discharged the following day.

Where possible, the original incisions are reused to avoid creating additional scars. Drains are sometimes placed and are typically removed before discharge or at the first follow-up appointment.

Recovery is generally similar to recovery from the original augmentation, although patients undergoing more complex revisions take longer. You’ll wear a surgical bra for several weeks. Lifting, vigorous exercise and overhead activity should wait around six weeks while the tissues heal and the new implant settles into position.

Most patients with desk-based work are back after one to two weeks. Recovery experiences vary between patients depending on the complexity of the operation and individual healing characteristics.

Replacement surgery generally has higher complication rates than primary augmentation, because the tissues have been operated on previously and the planes are no longer pristine. The recognised risks include:

Dr Henry Shepherd, BMed MD MS (Plast.) FRACS (Plast.) | Specialist Plastic Surgeon | AHPRA registration: MED 0001860545