Breast Implant Removal/Revision
Explant, capsulectomy, and implant exchange surgery
Breast implant removal and revision surgery encompasses a range of procedures performed on patients with existing breast implants. These procedures include implant removal (explant) with or without replacement, capsulectomy (removal of the scar tissue capsule surrounding the implant), and implant exchange (replacing existing implants with new ones of a different size, type, or profile). The specific procedure performed depends on the patient's reason for surgery, current implant condition, and desired outcome.
Patients seek implant revision for a variety of reasons including capsular contracture, implant rupture or deflation, dissatisfaction with size or shape, implant malposition, rippling, asymmetry, and concerns about breast implant illness (BII). Some patients simply desire implant removal after years of having implants, choosing to return to their natural breast shape. Others wish to exchange their implants for a different type or size to update their look or address age-related changes.
Breast implant revision surgery requires considerable expertise, as working with previously operated tissue presents unique challenges including scar tissue management, altered blood supply, and thinned native breast tissue. A board-certified plastic surgeon experienced in revision breast surgery is essential for achieving optimal outcomes.
Overview
Breast implant revision surgery is a broad category that addresses the wide range of concerns that can arise over the lifespan of breast implants. Since breast implants are not lifetime devices, most patients with implants will eventually require some form of revision surgery, whether for medical necessity or personal preference. The FDA reports that approximately 20 to 40 percent of patients with cosmetic breast augmentation undergo reoperation within 8 to 10 years of their initial surgery [2].
The most common indications for revision include capsular contracture, which is the tightening and hardening of the scar tissue capsule that naturally forms around any implant. Capsular contracture is graded on the Baker scale from I (soft, natural-feeling) to IV (hard, painful, distorted), with Grade III and IV typically requiring surgical intervention [1]. Other common reasons include implant rupture, which may be silent (detectable only on imaging) for silicone implants or immediately apparent for saline implants; implant malposition such as bottoming out, symmastia, or lateral displacement; visible rippling or wrinkling; size or shape dissatisfaction; and concerns related to breast implant illness.
Breast implant illness (BII) is a term used by patients and some physicians to describe a constellation of systemic symptoms that some individuals attribute to their breast implants. Symptoms may include chronic fatigue, joint and muscle pain, cognitive difficulties, skin rashes, and autoimmune-like symptoms. While the medical community continues to study BII, many patients report significant improvement in symptoms following explant surgery. The FDA has acknowledged patient reports and recommends that healthcare providers take these concerns seriously [2].
The decision to remove, replace, or revise breast implants is highly personal and should be made in consultation with a board-certified plastic surgeon who has extensive experience in revision breast surgery. The surgeon will evaluate the patient's current implant condition, tissue quality, chest wall anatomy, and aesthetic goals to develop an individualized surgical plan. In many cases, additional procedures such as a breast lift, fat grafting, or capsulectomy are performed in conjunction with the primary revision to optimize results.
Advances in implant technology, surgical techniques, and understanding of implant-related complications have improved outcomes for revision patients. Modern cohesive gel implants, pre-pectoral placement techniques, acellular dermal matrix support, and fat grafting for contour refinement all contribute to better revision results than were achievable in previous decades.
Techniques & Approaches
Implant removal (explant) involves removing the breast implants and, in most cases, the surrounding capsule. A total capsulectomy removes the entire scar tissue capsule and is often recommended for patients with capsular contracture, implant rupture (particularly silicone), or those who wish to have all implant-related material removed. An en bloc capsulectomy removes the capsule and implant together as a single unit without opening the capsule, which is preferred in cases of silicone implant rupture to prevent silicone from contacting surrounding tissue [1]. A partial capsulectomy removes only a portion of the capsule and may be appropriate when the capsule is thin and non-problematic.
Implant exchange involves removing the existing implants and replacing them with new ones. Patients may choose to change implant type (saline to silicone or vice versa), size (larger or smaller), shape (round to anatomical), profile (low to high projection), or placement (subglandular to submuscular or vice versa). The exchange procedure often includes capsulotomy (releasing the capsule) or capsulectomy to create an optimal pocket for the new implant. When changing implant size significantly, a breast lift may be performed simultaneously to address excess skin.
Capsulectomy with implant replacement is the standard approach for capsular contracture. The hardened capsule is removed, the pocket is modified as needed, and a new implant is placed. Strategies to reduce the risk of recurrent contracture include changing the implant pocket plane, using acellular dermal matrix to reinforce the pocket, using textured or smooth implants depending on the clinical situation, and postoperative implant displacement exercises [1].
For patients who choose explant without replacement, the surgeon may recommend a concurrent breast lift (mastopexy) to address the excess skin and tissue laxity that typically results from implant removal. Fat grafting can be performed at the time of explant or as a secondary procedure to restore some volume and improve breast contour for patients who desire augmentation without implants.
Who Is a Good Candidate?
Ideal Candidates
Candidates for breast implant revision include any patient with existing breast implants who is experiencing complications, dissatisfaction with their current results, or a desire to change or remove their implants. Specific indications include capsular contracture (Baker Grade III or IV), implant rupture or deflation, implant malposition, visible rippling, size or shape dissatisfaction, and concerns about breast implant illness.
Patients who have had their implants for many years and wish to update to modern implant technology are also good candidates. Those who have experienced life changes such as significant weight fluctuations, pregnancy, breastfeeding, or aging and wish to update their breast appearance may benefit from revision surgery. Candidates should be in good overall health and have realistic expectations about what revision surgery can achieve.
Not Suitable For
Patients with active breast infections, untreated breast cancer, or uncontrolled systemic illnesses should not undergo elective revision surgery until these conditions are appropriately managed. Patients who are pregnant or breastfeeding should postpone the procedure. Those who smoke and are unwilling to quit face increased risks of wound healing complications, particularly with more extensive procedures such as en bloc capsulectomy combined with a breast lift.
Patients with unrealistic expectations about achieving perfection through revision should undergo thorough counseling. Revision surgery is inherently more challenging than primary surgery, and achieving the ideal result may require more than one procedure. Patients should understand the limitations of revision surgery given their specific anatomy and tissue quality.
Risks & Benefits
Benefits
Breast implant revision surgery allows patients to address complications, update their appearance, or transition away from implants according to their evolving needs and preferences. For patients with capsular contracture, revision provides relief from discomfort and restores a natural breast feel and appearance. For those with ruptured implants, revision removes compromised material and restores breast shape with new implants or the patient's own tissue.
Patients who choose implant exchange benefit from access to modern implant technology, which has improved significantly in terms of natural feel, durability, and safety. Upgrading from older implant styles to current-generation devices can provide a meaningful improvement in both aesthetics and peace of mind.
For patients who choose explant, the procedure offers freedom from the ongoing monitoring, potential complications, and future surgeries associated with breast implants. Many explant patients report an improved sense of well-being, resolution of breast implant illness symptoms, and satisfaction with their natural breast appearance. The ability to choose from multiple approaches, from simple explant to explant with lift and fat grafting, allows the procedure to be tailored to each patient's goals.
Risks & Considerations
Breast implant revision surgery carries the standard surgical risks of infection, bleeding, anesthesia complications, and poor wound healing. Revision surgery is generally considered more technically challenging than primary augmentation due to scar tissue, altered anatomy, and thinned native tissue, which can increase complication rates [1].
Specific risks include recurrent capsular contracture following capsulectomy, which occurs in a subset of patients despite preventive measures. Implant malposition is a risk with any implant surgery and may be more likely in revision cases due to pocket irregularities. Changes in breast and nipple sensation may occur, particularly with extensive capsulectomy. Skin irregularities, visible rippling, and contour deformities are more common in revision surgery, especially when tissue coverage is compromised.
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), a rare type of T-cell lymphoma identified predominantly in patients with textured surface implants, is an important consideration for revision patients [2]. Breast implant-associated squamous cell carcinoma (BIA-SCC) is another rare cancer risk that has been identified [2]. While both conditions are very rare and treatable when caught early, patients with existing implants should be aware of these risks and discuss them with their surgeon, particularly when making decisions about implant exchange versus explant.
For patients undergoing explant, there is a risk of unsatisfactory cosmetic appearance due to tissue atrophy and skin laxity that developed during implant wear. Hematoma, seroma, and wound healing complications are possible, particularly with en bloc capsulectomy, which involves more extensive tissue dissection. Patients should discuss all potential risks and complications with their surgeon during the consultation to make an informed decision about proceeding.
Alternative Procedures
Patients with mild capsular contracture (Baker Grade II) may benefit from conservative management including implant displacement exercises, anti-inflammatory medications, and close monitoring. However, capsular contracture that progresses to Grade III or IV typically requires surgical intervention for definitive treatment.
For patients who wish to enhance breast appearance without replacing implants, fat transfer can be used to improve contour, fill defects, and add modest volume. This approach is particularly useful for patients transitioning from implants to a natural breast while maintaining some fullness. Non-surgical treatments are limited for most implant-related issues, as structural problems with the implant or capsule generally require a surgical solution.
Patients considering revision solely for size change should explore whether their goals can be achieved with a less invasive approach. In some cases, adding fat grafting around existing implants can provide subtle enhancement without full implant exchange. However, for significant size changes, implant exchange remains the most reliable approach.
Preparation & Recovery
Pre-Surgery Preparation
Preparation for breast implant revision begins with a comprehensive consultation, during which the surgeon reviews the patient's surgical history, examines the current breast implants and tissue quality, and discusses the patient's goals and concerns. Imaging studies such as MRI or ultrasound may be ordered to assess implant integrity, particularly if rupture is suspected [2]. The surgeon will review any available records from the original augmentation, including implant type, size, and placement details.
Based on the evaluation, the surgeon will develop a customized surgical plan and discuss the recommended approach, expected outcomes, and potential risks. Patients should stop smoking at least four to six weeks before surgery and discontinue blood-thinning medications and supplements as directed. Pre-operative laboratory work may be required depending on the patient's health status and the complexity of the planned procedure.
Patients should arrange for transportation home, assistance for the first 24 to 48 hours, and time off work. Recovery supplies including a surgical support bra, prescribed medications, ice packs, and comfortable front-opening clothing should be prepared in advance.
Post-Surgery Care
Post-operative care following implant revision is similar to primary breast augmentation or lift surgery. Patients will wear a surgical support bra or compression garment continuously for four to six weeks. Drains may be placed, particularly after capsulectomy, and are typically removed within the first one to two weeks. Incisions should be kept clean and dry, with dressings changed according to the surgeon's instructions.
Pain and discomfort are managed with prescribed medications and generally improve within the first week. Swelling and bruising are expected and may be more pronounced than after primary augmentation, particularly with extensive capsulectomy. Patients should sleep on their back in an elevated position for the first two to four weeks.
Activity restrictions include avoiding heavy lifting and strenuous upper body exercise for four to six weeks. Light walking is encouraged starting the day after surgery. Follow-up appointments are typically scheduled at one week, three weeks, and six weeks post-surgery. For patients who have undergone capsulectomy with new implant placement, implant displacement exercises may be recommended to help prevent recurrent capsular contracture.
Recovery Timeline
1-2 days
Rest at home with prescribed pain management, limited arm movement
3-5 days
Gradual improvement in comfort, light walking encouraged
1 week
First post-operative visit, drains removed if applicable, return to light desk work
2 weeks
Bruising and swelling begin to decrease, driving may resume
3-4 weeks
Return to most daily activities, continued restriction on heavy lifting
6 weeks
Cleared for exercise and full physical activities
3 months
Breast shape continues to settle, swelling resolved
6 months
Final results visible, scars continue to fade
Expected Results
The expected results of revision surgery depend on the specific procedure performed and the indication for surgery. Patients undergoing implant exchange for size or type change can expect results comparable to their original augmentation, with the new implants providing the desired volume, shape, and feel. For capsular contracture revision, patients can expect relief from the hardness, discomfort, and distortion caused by the contracture, with the breast returning to a softer, more natural feel.
Patients who choose explant without replacement should have realistic expectations about their post-explant breast appearance. The breasts will be smaller and may have some degree of ptosis, skin laxity, or volume deflation. A concurrent breast lift can address excess skin, and fat grafting can restore some fullness. The final appearance depends on the amount of natural breast tissue present, the duration of implant wear, and the patient's skin elasticity. Most patients who choose explant report satisfaction with their decision and relief from implant-related concerns.
For patients with breast implant illness symptoms, many report significant improvement or resolution of symptoms following explant surgery, particularly when a total or en bloc capsulectomy is performed. However, symptom improvement is not guaranteed, and patients should discuss expectations thoroughly with their surgeon. Recovery of final breast shape typically occurs over three to six months as tissues heal and settle.
Frequently Asked Questions
What happens to my breasts after implant removal?
After implant removal without replacement, your breasts will return to a smaller size and may appear deflated, saggy, or have loose skin depending on how long you had implants, your skin elasticity, and the size of the implants removed. Many surgeons recommend combining explant with a breast lift to address excess skin and restore a more youthful breast shape. Fat grafting can also be performed to add some natural volume. Your surgeon will discuss the expected post-explant appearance and any recommended complementary procedures during your consultation.
Source: ASPS, Mayo Clinic
What is en bloc capsulectomy?
En bloc capsulectomy is a surgical technique in which the breast implant and the entire surrounding scar tissue capsule are removed together as a single, intact unit without opening the capsule. This approach is often preferred for patients with ruptured silicone implants (to prevent silicone from contacting surrounding tissue) and for patients seeking explant for breast implant illness. En bloc capsulectomy is more technically demanding than standard capsulectomy and requires a surgeon experienced in this technique. Not all capsules can be removed en bloc due to anatomical constraints, particularly where the capsule adheres to the chest wall.
Source: ASPS, FDA
How do I know if my implants need to be replaced?
Signs that your implants may need replacement include changes in breast shape or firmness (which may indicate capsular contracture), visible rippling or wrinkling, pain or discomfort in the breast, and visible deflation (saline implants). Silicone implant rupture can be silent, meaning there are no obvious symptoms, which is why the FDA recommends screening via MRI or ultrasound starting 5-6 years after placement and every 2-3 years thereafter. Regular follow-up with your plastic surgeon allows for ongoing monitoring. If you have concerns about your implants at any time, schedule an evaluation with your surgeon.
Source: FDA, ASPS
Sources & References
- Breast Implant Revision Surgery — American Society of Plastic Surgeons (ASPS) Accessed March 2026
- Breast implant removal — Mayo Clinic Accessed March 2026
- Breast Implants — U.S. Food and Drug Administration (FDA) Accessed March 2026
Content last reviewed: March 11, 2026
Medical Disclaimer
Breast implants are not lifetime devices; the FDA recommends MRI or ultrasound screening 5-6 years post-surgery and every 2-3 years thereafter to detect silent rupture. Symptom improvement following explant for breast implant illness is not guaranteed. This information is for educational purposes only and does not constitute medical advice.
Not Medical Advice. The information on this page is provided strictly for educational and informational purposes. It is not intended to be, and must not be taken as, medical advice, a medical diagnosis, or a recommendation for any specific treatment or procedure. This content does not establish a physician-patient relationship.
Consult a Qualified Professional. Always seek the advice of a board-certified plastic surgeon or other qualified healthcare provider before making any decisions about medical treatment. Never disregard professional medical advice or delay seeking it because of something you have read on this website.
Individual Results Vary. The outcomes, recovery timelines, complication rates, and cost estimates described here are general approximations based on published medical literature and may differ significantly based on your individual anatomy, health status, surgeon experience, geographic location, and other factors. No specific results are guaranteed or implied.
Sources and Currency. Content is informed by peer-reviewed medical literature and professional society guidelines, last reviewed March 11, 2026. Medical knowledge evolves continuously, and this information may not reflect the most current research or clinical practice at the time you read it.
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Quick Facts
Cost Information
Average cost range in the US
Factors affecting cost:
The cost of breast implant revision varies significantly based on the specific procedure performed. A straightforward implant exchange is generally less expensive than a complex revision involving en bloc capsulectomy, pocket modification, and concurrent breast lift. The cost of new implants, if applicable, is included in the total price. Implant manufacturers may offer warranty replacement for implants that rupture within the warranty period, which can offset some costs.
Surgeon experience in revision breast surgery is a significant factor, as revision procedures require advanced skills and expertise. Geographic location and facility fees also influence pricing. Unlike breast reconstruction, most implant revision procedures are considered elective and are not covered by health insurance, though some insurance plans may cover medically necessary procedures such as explant for rupture. Financing options are available through many plastic surgery practices.
Note: Costs vary by location, surgeon experience, and specific patient needs. Always get personalized quotes during consultations.
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