Removal and replacement of breast implants may be required for many reasons. There may be a complication with the implant requiring removal.

Other reasons for removal and replacement of breast implants are mainly cosmetic. These relate to breast symmetry and position. Sometimes although good implant position and symmetry was achieved intraoperatively, differential healing between each breast may result in a degree of breast asymmetry in the first couple of months following surgery.

If there is no evidence of developing capsular contracture then the asymmetry will probably settle over the first six months and it is probably best not to reoperate again at that stage unless the asymmetry is significant. The final reason for implant exchange is usually related to implant size. There is a small percentage of women who are not happy with their new breast size following breast augmentation or circumstances change (usually children and breast feeding), which necessitate implant removal with or without replacement with a smaller or larger breast implant.

Secondary breast augmentation (breast implant exchange) is much more difficult than initial breast implant surgery, due to scarring or silicon gel leakage. To create a natural breast contour the surgeon needs to remove all scar tissue as well as the existing implants and create a new chest wall pocket to allow replacement with new breast implants. It is not unusual for women who have had problems with their implants, be they silicon gel or saline filled implants, to request replacement with a different implant so their previous complication can be avoided again in the future. It should be noted that when scarring occurs due to a ruptured silicone gel implant, that removal may not remove the propensity to further scarring due to residual silicon gel disseminated through the breast tissue which is virtually impossible to remove completely.

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