What is a breast implant exchange?
A breast implant exchange is the simplest of the second breast surgeries. The implants placed at your breast augmentation come out through the scar you already have, usually in the fold under the breast, and a new pair goes into the same pocket, over or under the muscle exactly as before. Nothing else is operated on: the thin capsule of scar tissue around each implant stays, and the pocket is neither tightened nor moved. That is why the surgery is short and the recovery and the price are those of a first augmentation.
The line that matters is the one between an exchange and a breast revision. When a capsule has hardened and has to come out (a capsulectomy), when a pocket has stretched, dropped or joined its neighbor and has to be rebuilt, when a Strattice sheet is needed to hold a repair, or when the nipple has dropped and a lift belongs in the plan, the operation is a breast revision and is priced as one. Dr. Cat examines the capsules and the pockets at the consultation and tells you which surgery you need; our page on breast implant problems describes the signs.
Reasons to exchange breast implants
- Age: Dr. Cat recommends exchanging silicone implants about every 8 to 10 years, to reduce the chance of a silent leak
- A change of size, up or down
- A saline to silicone exchange, for the softer feel and less rippling
- A saline implant that has deflated, or a silicone rupture found on imaging while the capsule is soft and the gel has stayed inside the shell
- An implant recalled or discontinued by its manufacturer
- A different profile or a newer cohesive gel, in the same footprint
Who is a good candidate for a breast implant exchange?
Most of Dr. Cat's implant exchange patients are women whose first augmentation went well and who are now at the age of their implants or at a change of mind. The examination decides the rest: the same wish, new implants, is a simple exchange in a soft breast and a revision in a firm one. Our page on uneven breasts covers two sides that differ, which an exchange can even with a different size on each side.
You may be a good candidate if
- Your implants are 8 to 10 years old, or older, and both breasts are still soft and in position
- You want a different size, profile or filling, and your nipple sits at or above the fold
- A saline implant has deflated, or imaging has found a rupture in a soft capsule
- Good health, a stable weight, at least three months past breastfeeding, and no nicotine
A different operation, if
- One breast has turned firm, high or distorted, an implant has slid below the fold or toward the armpit, or the pockets meet in the middle: that is a breast revision
- A silicone implant has ruptured and gel has escaped the shell: the capsule comes out with it
- Your nipple sits at or below the fold: a new implant will not raise it, so the exchange is combined with a lift (see breast lift vs augmentation)
- You want the implants out for good: that is breast implant removal, in almost every case with the capsules taken out
- You would rather have no device: implants vs fat transfer explains what your own fat can and cannot do
- You want a tummy tuck or a Brazilian butt lift the same day: as with a breast augmentation, Dr. Cat stages those on separate days
How often should breast implants be replaced?
Silicone implants on a schedule, saline implants when they tell you. A silicone rupture is often silent, because the cohesive gel keeps its shape inside the capsule, so Dr. Cat recommends exchanging silicone implants about every 8 to 10 years rather than waiting for a leak to be found on a screening scan. A saline implant announces a leak by deflating within days. Our post on how long breast implants last covers the signs to watch for and the screening schedule.
Types of breast implant exchange
Saline to silicone exchange
The most requested change of filling. A saline implant is placed empty and filled in the pocket; a silicone implant goes in already filled with cohesive gel, which feels closer to breast tissue and ripples least. Because it is pre-filled, the incision in the fold is the usual route; where the first surgery used the areola, Dr. Cat tells you whether that scar can be reused. Our comparison of saline vs silicone implants goes through every point.
Implant exchange with a size change
Up or down. Dr. Cat fits the width of the new implant to the base of your breast first, because an implant wider than the footprint thins the tissue at its edges, then reaches the volume through the profile; her implants range from 175 cc "ballet breasts" to as full as 700 cc. A moderate change is a simple exchange; a large step down leaves skin that needs a lift, and a large step up can need the pocket adjusted, which makes it a revision. Our guide to breast implant sizes has a cc chart.
Implant exchange with a lift
When the breast has slid off the implant after pregnancy, breastfeeding or weight loss, the nipple sits at or below the fold and the implant sits high above an emptier breast. A new implant does not fix that; a lift with the exchange does. Dr. Cat lifts and reshapes the tissue first, then places the new implant: about $39,000 to $44,000 with a periareolar lift and about $65,000 to $75,000 with a full lift, plus the implants. A lift done before that needs redoing is a revision breast lift; our page on saggy or deflated breasts explains how the nipple position decides.
How Dr. Cat does it
Dr. Cat is a board-certified plastic surgeon who completed two surgical residencies, one in head and neck surgery, microvascular and facial reconstructive surgery, and advanced training in general plastic and reconstructive surgery, Harvard-educated and UCLA trained. She has had breast augmentation and a revision herself, and has performed hundreds of breast revisions. An implant exchange is where that experience shows as restraint: she operates on what needs it and leaves soft capsules and good pockets alone.
The incision: the scar you already have
Dr. Cat opens through your previous incision, in the crease under the breast or along the lower edge of the areola, so no new scar is added. The old implant comes out through it, the pocket is inspected and washed, and the new implant goes in the same way. The scar is re-closed in meticulous layers, and with silicone scar care from two weeks many patients find it heals thinner than before.
The implants: Mentor, sized to your frame, tested for symmetry
Dr. Cat uses Mentor implants. At the consultation she measures the base width of each breast and the tissue over it, has you hold a saline and a silicone implant, and shows you the candidate sizes on your own frame with sizers in a bra. In the operating room she tests the pockets with sizers where the two sides differ, and inserts each implant with a no-touch technique to minimize contamination.
Surgery day, and home the same day
A simple implant exchange takes about one to three hours under general anesthesia with local anesthetic in the breast, so you wake numb rather than sore, with a board-certified physician anesthesiologist for the whole case, in Dr. Cat's QUAD A accredited surgery center on Rodeo Drive. After one to two hours in recovery you go home with the person driving you, and someone stays the first 24 hours; no aftercare-facility night is needed. Dr. Cat sees you the day after surgery.
Breast implant exchange recovery timeline
Recovery after a simple implant exchange follows a first augmentation. For the long version, read our breast augmentation recovery guide, week by week.
- Surgery dayYou wake numb rather than sore, spend one to two hours in recovery in your surgical bra, and go home with the person driving you; someone stays 24 hours. Implants that look high or tight are normal.
- Days one to threeDr. Cat checks the incisions the day after surgery. Expect tightness rather than pain, managed with Tylenol. Sleep on your back propped up, wear the bra day and night, and walk often.
- One weekMost patients are off all pain medication and back at desk work. Arms below shoulder height for two weeks, no lifting, no underwire.
- Two to four weeksDr. Cat checks the old scar at two weeks and starts silicone sheets, then scar gel. The new implants begin to settle and most swelling is gone by a month.
- Six weeksThe restrictions end: all exercise, chest and shoulders included, and side sleeping. A supportive bra continues for up to two months.
- Three to six monthsThe new implants drop and soften and the final shape shows, later under the muscle than over it.
- One year and afterThe scar has faded again to a pale line. From here: yearly check-ups, the FDA screening scans for silicone implants, and the next planned exchange about 8 to 10 years on.
Risks and safety
An implant exchange carries the risks of a first augmentation plus one of its own: the chance that a simple exchange turns out, once the breast is open, to need capsule or pocket work.
What can go wrong
- A hematoma in the first days (one breast suddenly larger, tighter and more painful) or an infection at the incision
- Capsular contracture around the new implant: the breast turns firm, rides higher or looks distorted, most often in the first year
- A capsule or a pocket that proves firmer or more stretched than the examination suggested, so the surgery becomes a revision
- Rippling or a visible edge in thin tissue, malposition, asymmetry, or a size that does not match what you pictured
- Changes in nipple sensation, usually temporary, anesthesia risks, and a silent rupture years later, the reason for the screening scans
How Dr. Cat reduces these risks
- A careful examination of the capsules and the pockets at the consultation, and imaging when a rupture is suspected
- Sizing by measurement: a new implant no wider than the base of your breast, at a volume your tissue can carry for another decade
- Silicone for most patients, smooth round Mentor implants as the default, and the boxed warning and the exchange schedule explained first
- The pocket washed, sizes tested before the final implants go in, and a no-touch technique to minimize contamination, with a physician anesthesiologist in a QUAD A accredited facility
- A meticulous layered closure, silicone scar care from two weeks, and follow-up visits from the day after surgery, then yearly
Call us right away for one breast suddenly larger, tighter or more painful than the other; a fever over 101°F, spreading redness, cloudy or foul-smelling drainage, or an incision that opens; or, months later, a breast that turns firm, rides higher or looks distorted after it had settled.
Call 911 first, then us, for calf pain or swelling in one leg, chest pain, or shortness of breath. And for anything that worries you: Dr. Cat and our staff are available throughout your recovery.
Breast implant exchange before and after photos
A simple exchange, done well, looks like a first augmentation done well: the same breast, softer or fuller or in a different filling, with the same scar. The six cases below are Dr. Cat's, and each is more than a simple exchange, because the patients who publish second-surgery photographs are usually the ones whose first surgery went wrong. BRV-0719: 600 cc silicone implants exchanged for 650 cc after capsular contracture, with a capsulectomy, a pocket repair and Strattice. BRV-0411: saline implants that had bottomed out, exchanged for 475 cc silicone with a pocket repair and a lift. BRV-0479: silicone implants exchanged with a pocket repair and a lift. BRV-0902: saline implants of twenty years exchanged for 650 cc silicone with pocket work and a periareolar lift. BRV-0848: a grade IV contracture corrected with a capsulectomy, Strattice and 350 cc implants. BRV-0997: an exchange after contracture, with a capsulectomy and a pocket repair. Look through Dr. Cat's breast revision before and after photos for the starting point closest to yours.
How much does a breast implant exchange cost in Beverly Hills?
A simple breast implant exchange with Dr. Cat, removal and replacement with no capsule or pocket work, is about $26,000 to $28,000 all in, plus the implants themselves, quoted in writing at your consultation. The figure covers her surgeon's fee, the operating room and the board-certified physician anesthesiologist, your surgical bra and your follow-up visits, and it sits close to a first breast augmentation (about $24,000 to $29,000) because it takes about as long. The implants are their own line on the quote, as a silicone pair or a saline pair, silicone costing more; a manufacturer's warranty, where it applies, is credited against that line. Because Dr. Cat prices by the work inside the breast, the other second surgeries have their own figures: a breast revision with pocket repair about $70,000 to $85,000, or about $98,000 to $101,000 with Strattice; implant removal with capsulectomy about $27,000 to $31,000; an explant with a lift about $66,000 to $71,000; a lift with implants about $65,000 to $75,000 full or $39,000 to $44,000 periareolar.
The price reflects one surgeon who performs every step herself, a physician anesthesiologist for the whole case, an accredited facility, and a plan that does not open a soft capsule or rebuild a pocket that is right. Please do not fall for a cheap implant swap: a pocket left stretched or a capsule left firm under a new implant becomes a revision that costs more than the exchange done well. Our breast revision cost guide sets every second breast surgery side by side.
Consultation fee and financing
A consultation with Dr. Cat is $500, or $1,500 for a revision consultation, credited in full toward your surgery. The practice partners with Cherry, its primary financing partner, and also accepts CareCredit and Alphaeon Credit; see financing and payment plans. An exchange of cosmetic implants is not covered by insurance, whatever the reason, though the imaging that confirms a rupture is often covered under your normal benefits.
Your consultation with Dr. Cat
It starts with a free 15-minute discovery call with our Patient Concierge, who books your consultation: in person on Rodeo Drive or, for out-of-town patients, a private video consultation through OnPatient, the HIPAA-secure patient portal. Bring your implant card or operative report, so Dr. Cat knows the make, size and placement of what is in place. She examines the softness of the capsules and the position of the pockets, measures the base width and the tissue over each implant, checks where the nipple sits against the fold, and orders imaging when a silent rupture is possible. Then she tells you plainly whether you need a simple exchange, a lift with it, or a breast revision, and you leave with an itemized written quote.
