Upgrade or replace existing implants for a fresh look.
Implant exchange replaces older breast implants and lets us address issues like rupture, contracture, or a change in size. This procedure can be combined with a breast lift to refine the shape while updating the implant material.
InquireBreast implant exchange is performed through the original inframammary incision whenever possible to avoid additional scarring. The capsule is assessed intraoperatively; if the capsule is soft and pliable, the implants are exchanged without capsular intervention. In cases of Baker Grade III or IV capsular contracture, partial or total capsulectomy is performed to remove the hardened scar tissue and provide a fresh tissue pocket. The new implant, selected in close collaboration with the patient, is placed in the appropriate anatomic pocket with triple-antibiotic irrigation. Hemostasis is verified before wound closure.
Implant exchange is a good fit for women who already have implants and want a change because of age, symptoms, rupture, capsular contracture, or a different size goal. You should be at stable weight, in good health, and should have a clear understanding of their goals for the revision.
Recovery from implant exchange is generally less intense than the initial augmentation, particularly when capsulectomy is not required. Swelling and tightness peak in the first three to five days and resolve substantially within two weeks. A supportive surgical bra is worn for three to four weeks. Most patients get back to desk work within five to seven days. Full activity resumes at four to six weeks. When a concurrent mastopexy is performed, recovery follows the longer mastopexy timeline.
Surgical bra worn continuously. Pain managed with medication; typically milder than primary augmentation.
Return to desk work. Swelling diminishes. Implants begin to settle in revised pocket.
Lifting restrictions ease. New implant shape becoming apparent. Light exercise may resume.
Full activity resumed. New implants reach final position and softness. Final breast shape appreciated.
Implant exchange carries risks similar to primary augmentation, with the additional consideration that the revised pocket may be unpredictable. When total capsulectomy is performed, the risk of seroma increases. In cases of severe capsular contracture, pocket conversion from subglandular to submuscular may be required, adding surgical complexity. Recurrence of capsular contracture after exchange is possible.
Complete implant removal without replacement (explantation) is an option for patients who wish to discontinue implants. A fat transfer to the breast at the time of explantation can preserve modest volume. Patients who are satisfied with their implant type but wish to change size may consider a straightforward size change without capsulectomy if the capsule is healthy.
Performed by Dr. Ruben Castro in Newport Beach, California