Breast implant exchange is a revision breast surgery that removes existing implants and replaces them with new ones. It may be chosen for aesthetic reasons, such as wanting a different size or a more natural look, or for medical reasons, such as implant rupture or capsular contracture. The procedure can also be combined with other techniques, for example a breast lift, to improve shape and position when the skin and tissues have changed over time.

What an implant exchange aims to achieve

An implant exchange can address concerns that develop months or years after an initial breast augmentation, including:

• A change in personal preference about size, shape, or implant type
• Changes after pregnancy, weight fluctuation, or natural ageing, including breast sagging
• Discomfort or a persistent “foreign body” sensation
• Implant-related complications such as rupture, leakage, malposition, or visible rippling
• Capsular contracture, where scar tissue around the implant tightens and may cause firmness, distortion, or pain

In some cases, the goal is to keep a similar breast size while improving comfort, symmetry, or overall breast shape. In others, the aim is a noticeable change in volume.

Who may be suitable, and when it may not be the right option

Implant exchange may be suitable if you:

• Have implants and want to change their size, profile, or shape
• Have breast asymmetry or an unsatisfactory result from previous surgery
• Have signs of capsular contracture such as increasing firmness, distortion, tightness, or pain
• Have suspected implant rupture or deflation
• Have implant malposition (for example, implants sitting too high, too low, too far apart, or too close together)
• Have breast sagging and would like to discuss whether a lift should be combined with implant replacement

There are also realistic limitations. An exchange alone cannot always correct significant sagging, stretched skin, or low nipple position. In these situations, a breast lift (mastopexy) may be recommended alongside implant replacement to achieve a balanced, stable result.

The procedure may be postponed or not advised if you are pregnant or breastfeeding, have an untreated breast infection, have certain uncontrolled medical conditions, or smoke heavily and are unable to stop, as this can increase wound-healing risks.

Specialist assessment and planning before surgery

Revision breast surgery requires careful planning because the breast tissues, implant pocket, and scar capsule may have changed since the original operation.

At your consultation, our plastic surgery team will discuss:

• Your current implants (type, size, placement above or below the chest muscle, and when they were inserted)
• Your goals, including desired size, shape, and how natural you want the result to look and feel
• Any symptoms such as pain, tightness, hardening, or changes in breast shape
• Your medical history, medications, and any previous breast surgery records if available

A physical examination assesses skin quality, breast position, asymmetry, and the condition of the implant pocket. Imaging such as ultrasound or MRI may be recommended if rupture is suspected or if there are unclear findings.

You will also be advised about factors that can influence longer-term results, including ageing, pregnancy, weight changes, and smoking.

How the procedure is generally performed

Breast implant exchange is usually carried out under general anaesthesia. The exact approach depends on your existing scars, implant position, and whether additional procedures are needed.

Access and implant removal

In many cases, the existing incision is used, often in the crease under the breast (inframammary fold), to avoid creating new scars. The old implant is removed, and the implant pocket is assessed.

Managing the capsule (scar tissue)

A thin capsule around an implant is normal. If the capsule has tightened or thickened, additional steps may be needed, such as:

• Capsulotomy: releasing the capsule to create more space
• Capsulectomy: removing part or all of the capsule, which may be recommended in more significant capsular contracture or when the capsule is abnormal

The most appropriate option is decided based on your symptoms, examination findings, and surgical goals.

Pocket adjustment and implant placement

The implant pocket may be reshaped to improve position and support. In some cases, the implant may be moved from above the muscle to below the muscle, or vice versa, depending on your anatomy and the issues being corrected.

A new implant is then placed. Implant choice is individual and may include different sizes, profiles, and shapes. Your surgeon will discuss what is realistically achievable for your body frame and tissue characteristics.

When a breast lift or reduction is added

If the breast skin has stretched or the nipple position has dropped, implant exchange alone may not restore a youthful shape. A breast lift can be performed at the same time to reposition the breast tissue and nipple, and to remove excess skin. Less commonly, a reduction may be appropriate if you want a smaller breast size and have significant heaviness or droop.

Recovery and what to expect after surgery

Recovery varies depending on whether the procedure is a straightforward implant exchange or combined with capsule surgery and or a breast lift.

In general, you can expect:

• Soreness, tightness, and swelling in the first days to weeks
• A supportive surgical bra to help reduce swelling and support healing
• Gradual settling of the implants over several weeks

Many patients find recovery easier than their original augmentation, but this is not always the case, particularly when extensive capsule work or a lift is performed.

Returning to normal activities

Typical guidance includes:

• Gentle walking soon after surgery to support circulation
• Avoiding heavy lifting and strenuous upper-body activity for several weeks
• A gradual return to exercise, with timing tailored to your procedure and healing progress

Driving is usually avoided until you are comfortable, no longer taking sedating pain medication, and can safely perform an emergency stop.

Follow-up and longer-term progression

Follow-up appointments are important to check wound healing, implant position, and early signs of complications. Scars typically look red or raised initially and then fade over months. Final scar maturation can take 12 to 24 months.

Temporary changes in nipple or breast skin sensation can occur. Sensation often improves with time, but it may not fully return to baseline.

Risks, limitations, and important considerations

All surgery carries risks. Your surgeon will explain these in detail and tailor the discussion to your situation. Key considerations include:

• Bleeding (haematoma) and swelling
• Infection, which may require antibiotics and, rarely, temporary implant removal
• Wound-healing problems and unfavourable scarring
• Changes in nipple or breast sensation, temporary or permanent
• Capsular contracture can recur, even after revision surgery
• Implant malposition, asymmetry, or dissatisfaction with size or shape
• Implant rupture or deflation over time
• Rippling or implant visibility, particularly in patients with thin breast tissue

If a breast lift is performed at the same time, there are additional risks related to skin and nipple blood supply and wound healing. These complications are uncommon but important to understand.

It is also important to know that breast implants are not considered lifetime devices. Many people keep implants for many years without problems, but future surgery may be needed due to ageing changes, implant wear, or new preferences.

Your consultation and ongoing support from our team

Choosing revision breast surgery can feel like a big step, especially if you have had complications or disappointment after previous surgery. Our approach is to provide clear, honest guidance and a plan that prioritises safety, proportion, and long-term stability.

From your first appointment, you will have continuity with our medical team, including pre-operative assessment, detailed consent and preparation advice, and structured follow-up after surgery. If concerns arise during recovery, you will have direct access to clinical support and timely review.

If you are considering an implant exchange, the next step is a consultation to assess your current implants and breast tissues, discuss your goals, and confirm whether implant replacement alone is appropriate or whether combining it with capsule surgery and or a breast lift would give the most reliable outcome.