Implant Revision with New Implants

Not every patient who wants their current implants addressed wants implants gone permanently. For those who simply want updated implants — newer technology, different size, repaired pocket, or replacement after rupture — revision with implant exchange is the right procedure.

Implant revision is breast implant replacement surgery — removal of existing implants and placement of new implants in the same operation. Indicated for implant rupture, capsular contracture Grade III-IV, implant aging (10-15+ years), size change preference, or switching from textured to smooth surface for BIA-ALCL risk reduction.

Reasons for implant exchange

• Implant rupture — saline (immediate deflation) or silicone (silent rupture detected on imaging)
• Capsular contracture — Baker III or IV requires capsulectomy and exchange
• Implant aging — many manufacturers recommend evaluation every 10-15 years
• Size change preference — patient wants smaller or larger volume
• Profile change — moderate to high or vice versa
• Style update — older textured implants exchanged for smooth surface (BIA-ALCL risk reduction)
• Aesthetic refinement — bottoming out, symmastia, double-bubble correction

The procedure

1. Existing implant removal — same pocket reopened
2. Capsule assessment and management — partial, total, or en-bloc capsulectomy depending on findings
3. Pocket revision — if needed (relocation from subglandular to submuscular, repair of malposition)
4. New implant placement — selected based on patient goals, tissue measurements, and current evidence
5. Tissue support — internal sutures or acellular dermal matrix (ADM) if structural support is needed

Implant selection in 2026

Current evidence favors:

• Smooth surface over textured (BIA-ALCL has been associated with textured implants)
• Cohesive silicone gel or saline based on patient preference
• Conservative volume — proper measurements drive size, not arbitrary goals
• Round vs anatomic — round preferred in most cases; anatomic in very specific anatomies

What we discuss in consultation

• Your original surgery records (implant brand, size, profile, placement, year)
• Current symptoms or concerns (pain, asymmetry, hardness, rupture)
• Imaging findings (MRI or ultrasound for rupture screening)
• Realistic outcomes given your tissue, age, and history
• Whether revision is the right choice — sometimes permanent explant serves the patient better