Breast Implant Removal and Replacement in Sydney

With Dr. Mark Kohout

Breast implants are not lifetime medical devices, and over time some patients may consider breast implant removal, replacement or another form of breast revision surgery. Reasons can include implant rupture, capsular contracture, discomfort, implant movement, changes in breast tissue or a change in personal preference. For people researching breast implant removal and replacement in Sydney, understanding the condition of the existing implant, surrounding capsule, implant pocket and breast tissue is an important part of deciding whether further treatment may be appropriate.

Dr Mark Kohout is a Sydney-based Specialist Plastic Surgeon with more than 25 years of practice in cosmetic and reconstructive surgery. His current practice includes breast revision procedures such as implant removal, implant exchange, capsule surgery, implant-pocket adjustment and breast tissue reshaping where clinically appropriate. This guide explains the main reasons patients consider revision surgery, the differences between implant removal and replacement, capsulectomy, implant-related conditions, recovery, risks and what to expect during consultation.

What Is Breast Implant Removal and Replacement?

Breast implant removal involves surgically removing an existing breast implant. Some patients have their implants removed without replacement, while others require additional treatment of the scar capsule or breast tissue. The extent of surgery depends on the implant condition, previous procedures, capsule characteristics and the reason the implants are being removed.

Breast implant replacement, also known as implant exchange, involves removing the existing implants and placing new implants. Revision surgery can also require modification of the implant pocket or scar capsule. It is therefore different from simply repeating a first breast augmentation and must be planned around anatomy that has already undergone surgery.

Breast revision may involve:

Implant removal without replacement
Removal and replacement of breast implants
Partial or complete capsulectomy
Capsulotomy or release of scar tissue
Adjustment of the implant pocket
Change in implant size, profile or position
Mastopexy where clinically appropriate
Fat transfer in selected cases
Staged surgery when a combined operation is not appropriate

Why Do Patients Consider Breast Implant Removal or Replacement?

There is no single reason for seeking breast implant revision. Some patients have a specific implant-related complication, while others notice gradual changes to their breasts or decide that they no longer want their current implants. The reason for revision influences both the investigations required and the surgical options that may be discussed.

The Therapeutic Goods Administration advises that breast implants are not lifetime devices. The likelihood of requiring another procedure generally increases the longer implants remain in place. This does not mean that every implant automatically requires surgery at a particular date; symptoms, examination findings, imaging and individual circumstances also need to be considered.

Reasons for seeking assessment may include:

Capsular contracture
Implant rupture or saline implant deflation
Implant movement or malposition
Rippling or visible implant edges
Breast asymmetry
Persistent firmness or discomfort
Changes following pregnancy or breastfeeding
Changes associated with weight fluctuation
Changes in breast tissue over time
A preference for different implant dimensions
A decision to have implants removed
Findings identified on breast imaging

How Long Do Breast Implants Last?

Breast implants should not be regarded as permanent medical devices. The TGA advises that implants are often removed or replaced after approximately 10 to 15 years, although this is not a compulsory replacement schedule. Some implants require revision sooner, while others may remain in place longer without a clinical indication for immediate surgery.

Implant age is therefore only one part of assessment. Patients with longstanding implants may benefit from knowing the manufacturer, implant type, surface and date of their original surgery. Implant cards and previous operation reports can be useful when planning revision, although assessment can still proceed when these records are unavailable.

Review of older implants may include:

Implant age and type
Manufacturer information where available
Smooth or textured implant surface
Silicone or saline filling
Previous implant procedures
Current breast symptoms
Changes in implant position
Clinical examination
Ultrasound or MRI where indicated
Discussion about continued monitoring or revision

Capsular Contracture and Capsule Surgery

The body normally forms scar tissue around a breast implant. This layer is known as the capsule and is an expected response to an implanted medical device. In some patients, however, the capsule can become thicker or tighter and contract around the implant. This is known as capsular contracture.

Capsular contracture varies in severity. It may cause increased firmness, discomfort, distortion of the breast or a change in implant position. Treatment depends on the degree of contracture, the implant condition, previous operations and the surrounding tissues. Complete capsule removal is not automatically required in every case.

Possible approaches can include:

Monitoring in selected circumstances
Capsulotomy to release a tight capsule
Partial capsulectomy
Total capsulectomy
Implant removal
Implant exchange
Modification of the implant pocket
A combination of capsule and implant procedures

Breast Implant Rupture: What Does It Mean?

A ruptured breast implant can present differently depending on its contents. When a saline implant ruptures, the breast commonly loses volume because the saline escapes and is absorbed by the body. Silicone implant rupture may be less obvious because the silicone can remain contained within the surrounding capsule.

For this reason, a silicone implant rupture may sometimes be detected on imaging rather than through visible changes alone. Ultrasound or MRI may be recommended where rupture is suspected. If rupture is confirmed, management depends on the type of implant, capsule findings, symptoms and whether the patient wishes to have replacement implants.

Assessment may involve:

Review of the patient’s implant history
Clinical breast examination
Ultrasound where indicated
MRI where appropriate
Assessment of the surrounding capsule
Consideration of silicone outside the implant shell
Implant removal where required
Discussion of replacement if implants are to be retained
Capsule treatment based on operative and imaging findings

What Is a Capsulectomy?

A capsulectomy involves surgically removing part or all of the scar capsule surrounding a breast implant. It may be considered when there is significant capsular contracture, implant rupture, abnormal capsule tissue or another clinical indication. The amount of capsule removed should be determined according to the individual circumstances.

More extensive capsule surgery can add complexity because the capsule may be closely attached to the chest wall or surrounding structures. For this reason, complete removal should not be presented as necessary for every implant-removal procedure. Potential benefits need to be considered alongside the additional surgical risks.

Terms patients may encounter include:

Partial capsulectomy: removal of part of the capsule
Total capsulectomy: removal of the entire capsule
Total intact capsulectomy: removal of the complete capsule as one specimen where technically possible
Capsulectomy with implant removal
Capsulectomy with implant replacement
Pathology examination where clinically indicated

En Bloc Capsulectomy, Breast Implant Illness and BIA-ALCL

The term en bloc capsulectomy is frequently used online but has a specific surgical meaning. It should not be used interchangeably with total capsulectomy. En bloc removal generally refers to removal of the implant and capsule with a margin of surrounding tissue in circumstances involving suspected or confirmed implant-associated malignancy. It is not a routine requirement for standard breast implant removal.

Some patients also report systemic symptoms commonly described as breast implant illness, or BII. The TGA recognises reports of symptoms including fatigue, cognitive difficulties, rashes, hair changes and joint or muscle discomfort, while noting that other medical causes should also be investigated. BIA-ALCL is a separate condition: it is a rare lymphoma associated particularly with exposure to textured breast implants and requires specific medical investigation.

Important points include:

BII describes a reported group of systemic symptoms
Other possible medical causes should also be assessed
Symptom change following implant removal cannot be predicted for an individual
En bloc capsulectomy is not routinely required for BII
BIA-ALCL is not breast cancer
BIA-ALCL commonly involves fluid or capsule tissue around an implant
New swelling or a breast or armpit lump requires medical assessment
Routine implant removal is not recommended solely because an asymptomatic patient is concerned about BIA-ALCL

Implant Removal Without Replacement

Some patients decide that they no longer wish to have breast implants. In these cases, implants can be removed without inserting new devices. The capsule may be left partly or largely in place, partially removed or completely removed depending on the clinical findings and surgical plan.

After implants are removed, the breasts do not necessarily return to their appearance before the original augmentation. Skin and breast tissue may have stretched or changed over time. Implant size, years since implantation, pregnancy, breastfeeding, weight changes and previous surgery can all influence how the tissues settle after removal.

Options may include:

Implant removal alone
Implant removal with partial capsulectomy
Implant removal with total capsulectomy where indicated
Allowing the breast tissue to settle without additional surgery
Mastopexy where clinically appropriate
Selected use of fat transfer
Staging additional breast surgery until tissues have settled

Breast Implant Replacement or Implant Exchange

Patients who wish to continue having breast implants may consider implant exchange. A replacement procedure allows the existing implants to be removed and new implants selected according to the revised surgical plan, breast dimensions, tissue coverage and patient preferences.

Revision surgery may also require adjustment of the space that holds the implant. Over time, the implant pocket can stretch or change position, and scar tissue may alter the way an implant sits. Simply inserting a different implant without considering these factors may not address the underlying reason for revision.

Planning may take into account:

Implant width and dimensions
Implant volume
Implant profile
Existing pocket position
Breast tissue thickness
Condition of the capsule
Previous incision sites
Implant malposition
Differences between the breasts
Whether pocket repair is required
Whether additional breast tissue surgery is appropriate

Can Implant Revision Be Combined With Mastopexy?

Mastopexy can sometimes be performed at the same time as breast implant removal or replacement. It may be considered when the position of breast tissue or the nipple has changed, or when removal of an implant is expected to leave skin and breast tissue that may benefit from additional reshaping.

Combining operations also increases the extent of surgery and changes the scar pattern, healing requirements and potential complications. In some patients, staged surgery may be considered instead. Whether mastopexy forms part of breast revision therefore depends on examination and treatment planning rather than being an automatic component of implant removal.

Factors considered include:

Breast tissue position
Nipple position
Skin characteristics
Existing implant dimensions
Remaining breast tissue
Previous breast scars
Blood supply to the tissues
Whether replacement implants are planned
Required incision pattern
Whether staged surgery may be appropriate

What Happens During a Breast Revision Consultation?

A breast revision consultation allows Dr Kohout to review the reason a patient is considering further surgery. Previous procedures, implant details, symptoms, breast tissue, scars, capsule firmness and implant position can be assessed. Existing ultrasound, MRI and previous operation reports may also be reviewed where available. Dr Kohout’s current practice specifically includes implant exchange, removal, capsule procedures, pocket adjustment and selected breast tissue procedures.

Patients seeking cosmetic surgery in Australia are also subject to Medical Board requirements. Cosmetic surgery patients require a referral from an independent GP or other eligible medical specialist, and current guidelines require at least two pre-operative consultations. There must also be a cooling-off period of at least seven days after the required consultations and informed consent before surgery can be booked or a deposit paid.

A consultation may include:

Medical and surgical history
Review of previous breast procedures
Implant card or implant information where available
Assessment of breast and implant position
Review of scars and capsule firmness
Discussion of symptoms
Imaging review or referral for imaging
Discussion of surgical and non-surgical alternatives
Risks and limitations of proposed surgery
Expected recovery requirements
Opportunity to seek another medical opinion

How Is Breast Implant Removal or Replacement Performed?

Breast implant revision is generally performed under general anaesthesia in an appropriately accredited surgical facility. Where suitable, an existing incision may be reused to access the implant. The implant is removed, and the capsule, pocket and surrounding breast tissues are assessed according to the planned procedure.

Additional steps depend on the reason for surgery. Capsule tissue may be released or removed, the implant pocket may require adjustment, and replacement implants may be placed where planned. Mastopexy or another breast procedure may also be performed when clinically appropriate. Drains may be used in some cases.

Surgery may involve:

General anaesthesia
Access through an existing scar where appropriate
Removal of the existing implant
Assessment of the implant capsule
Capsulotomy or capsulectomy where indicated
Removal of silicone material where required
Implant-pocket adjustment
Placement of a replacement implant
Breast tissue reshaping where planned
Wound closure, dressings and possible drains

Recovery After Breast Implant Revision

Recovery varies depending on the extent of the procedure. Implant removal alone may involve different postoperative requirements from surgery involving complete capsulectomy, pocket reconstruction, implant exchange or concurrent mastopexy. Previous surgery and individual healing also influence recovery.

Swelling, bruising, tightness and discomfort can occur during the early postoperative period. Breast position and scars continue to change as healing progresses, so the early postoperative appearance should not be regarded as the final outcome. Return to work, exercise, lifting and driving should follow individual postoperative instructions.

Aftercare can include:

Surgical dressings
A postoperative support bra where recommended
Drain care when drains are used
Prescribed medication
Temporary limits on heavy lifting
Gradual return to physical activity
Monitoring the surgical wounds
Scheduled postoperative reviews
Reporting unexpected swelling, redness, pain or other concerns promptly
Allowing several months for tissues and scars to continue settling

Before and After Photos of Breast Implant Removal Surgery

View examples of individual breast implant removal cases.

Disclaimer

Individual results vary due to personal health factors and genetics, and all surgical procedures carry inherent risks that should be discussed with a qualified health professional.

Risks and Possible Complications

Breast implant removal and replacement are surgical procedures and carry risks. Revision breast surgery may be more involved than primary breast augmentation because previous operations can alter anatomy, scar tissue and the implant pocket. No surgical technique can remove all risk or guarantee a particular result.

The individual risk profile depends on the planned operation, previous surgery, tissue characteristics, general health, nicotine exposure and other factors. Patients should receive information about risks relevant to their proposed procedure before deciding whether to proceed. Medical Board advertising guidance specifically requires cosmetic-surgery advertising to provide appropriate information about risks and not minimise the complexity of surgery.

Potential complications can include:

Bleeding or haematoma
Infection
Fluid collection
Wound-healing difficulties
Changes in breast or nipple sensation
Altered or noticeable scars
Breast asymmetry
Persistent discomfort
Recurrent capsular contracture
Implant movement or malposition
Implant rupture
Rippling or implant visibility
Anaesthetic complications
Need for further surgery
Implant-associated conditions

Cost of Breast Implant Removal and Replacement in Sydney

The cost of breast implant revision in Sydney varies because there is no single operation performed for every patient. Implant removal alone involves different surgical requirements from implant replacement, while capsulectomy, pocket adjustment, mastopexy or other additional procedures can affect the overall cost.

A personalised written estimate can be provided after assessment and confirmation of the proposed surgery. Some procedures performed for an accepted medical indication may meet criteria for Medicare or private health insurance benefits, but eligibility varies and does not mean that all treatment costs will be covered. Dr Kohout publishes current breast surgery pricing information separately on his website.

Potential costs may include:

Surgeon’s fee
Surgical assistant fee
Anaesthetist fee
Hospital or theatre charges
Replacement implants where required
Imaging
Pathology where indicated
Postoperative garments
Additional procedures performed at the same operation
Other out-of-pocket expenses

Choosing a Specialist Plastic Surgeon for Breast Revision in Sydney

Revision breast surgery requires consideration of previous surgery as well as the current condition of the implants, capsule, pocket and breast tissue. Patients researching a practitioner can verify medical registration, specialist registration and qualifications independently through the Ahpra public register.

Dr Mark Kohout is a Specialist Plastic Surgeon with specialist registration in Surgery – Plastic Surgery, medical registration number MED0001133000 and more than 25 years of practice. His current Sydney practice includes primary and revision breast surgery. These qualifications and years of practice do not guarantee a particular surgical outcome, and patients may seek a second opinion before proceeding.

Questions patients may wish to discuss include:

What is causing the current implant or breast concern?
Is surgery necessary at this stage?
What alternatives are available?
Is capsule removal required?
Will the implant pocket need adjustment?
What scars are expected?
What are the procedure-specific risks?
What postoperative support is provided?
Could further breast surgery be required later?
Would a staged procedure be appropriate?

FAQs About Breast Implant Removal and Replacement in Sydney

Can breast implants be removed without being replaced?

Yes. Breast implants can be removed without placing another implant. The remaining breast tissue is then allowed to settle, or additional breast reshaping may be considered when clinically appropriate. The appearance after removal depends on implant size, skin and tissue characteristics, previous surgery and how the breasts have changed over time.

Does every breast implant removal require a capsulectomy?

No. Some patients require partial or complete capsule removal because of contracture, rupture or another clinical finding, while others may not require complete removal. The decision should take into account both the reason for surgery and the additional risks associated with capsule dissection.

What is the difference between total and en bloc capsulectomy?

Total capsulectomy means removing the complete implant capsule. En bloc capsulectomy has a more specific meaning and involves removing the implant and capsule with surrounding tissue in circumstances such as suspected or confirmed implant-associated malignancy. The terms should not be used interchangeably.

How do I know if my breast implant has ruptured?

A saline implant often loses volume after rupture. Silicone rupture can be less obvious because silicone may remain within the capsule. Changes in breast shape, firmness or discomfort warrant assessment, and ultrasound or MRI may be recommended where clinically indicated.

Can breast implant removal or replacement be combined with mastopexy?

It can be combined in selected patients. Whether this is appropriate depends on breast tissue, skin, nipple position, implant history and the amount of surgery required. In some situations, performing the procedures in stages may be discussed.

How long does recovery take after breast implant revision?

There is no single recovery timeframe because implant exchange, implant removal, capsulectomy and combined breast procedures differ in extent. Patients should follow the postoperative restrictions provided for their specific operation rather than relying on a standard online timetable.

When should I have my breast implants assessed?

Assessment is appropriate if you develop new swelling, increasing firmness, persistent discomfort, a breast or armpit lump, implant movement, a sudden change in breast shape or another unexplained change. A consultation can also be considered when you have no symptoms but wish to discuss removal or replacement.

Medical References

Evaluation of Major Complications Following Ruptured Implant Removal: A National Surgery Quality Improvement Program Database Analysis – https://academic.oup.com/asj/article/45/10/NP187/8219134
Explantation: Techniques and Outcomes – https://pubmed.ncbi.nlm.nih.gov/41826053/
A 20-Year Experience with Round Smooth Saline Breast Implant Explantation: Reasons, Trends, and Management – https://pubmed.ncbi.nlm.nih.gov/41023230/
Clinical Outcomes in Women with Breast Implant Illness After Removal Surgery: Experience from a Latin American Center – https://pubmed.ncbi.nlm.nih.gov/41136705/
Outcomes of Mastopexy Explantation: A Consecutive Series of 841 Patients – https://pmc.ncbi.nlm.nih.gov/articles/PMC13162023/
Changes to Chest Surface Anatomy Following Exchange From Anatomic Textured Implants to Smooth Round Implants in Breast Reconstruction: A Preliminary 3D Imaging Analysis – https://pmc.ncbi.nlm.nih.gov/articles/PMC12727474/
Breast Implants – https://www.ncbi.nlm.nih.gov/books/NBK441998/

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Considering a Change to Your Breast Implants? Start With a Clinical Assessment

Breast implant revision is not a standardised breast procedure, and the appropriate approach depends on the condition of the implants, capsule, implant pocket, breast tissue and the individual reason for seeking treatment. A consultation can help determine whether monitoring, implant removal, replacement, capsule surgery or another approach may be considered, while also providing an opportunity to discuss risks, limitations and expected recovery.

Dr Mark Kohout provides consultations for breast implant removal, replacement and revision surgery in Sydney and Orange, NSW. If you have concerns about existing implants or are considering a change, you can arrange a consultation to have your implant history, previous surgery, current concerns and relevant imaging reviewed before discussing the options that may be appropriate for your circumstances. All surgical procedures carry risks, and individual outcomes vary.

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Dr. Mark Kohout

With over 25 years of experience and Harvard training, Dr. Mark Kohout offers experienced plastic and reconstructive surgery at his Sydney and Orange clinics. His patient-first approach focuses on delivering safe, natural results tailored to your unique goals.

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Experienced Plastic Surgeon

Dr. Mark Kohout

A qualified plastic surgeon who operates with care and integrity, based in central Sydney with over 20 years of experience in the cosmetic field. His extensive training and experience assures patients they are in highly trained surgical hands. Dr. Kohout is a dedicated, friendly professional who is committed to providing the high quality care, support and results, alongside his compassionate team.

Dr Mark Kohout (MED0001133000)
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Specialist registration in Surgery – Plastic Surgery

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Dr Mark Kohout is a qualified plastic surgeon based in central Sydney, with over 20 years of experience in the field of cosmetic and reconstructive surgery. He draws on extensive surgical training and clinical experience to tailor care to the individual needs and goals of each patient.

Dr Kohout is known for his thoughtful, patient-centred approach, guiding individuals through each stage of their surgical journey — from initial consultation to post-operative care. Working alongside a compassionate and professional team, he is committed to providing high standards of care in a supportive and respectful environment.

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Disclaimer: Dr Mark Kohout (MED0001133000) a Registered Medical Practitioner, Specialist Plastic Surgeon. All surgical or invasive procedures carry risks and complications. We recommend seeking a second opinion from an appropriately qualified medical practitioner before proceeding with any surgery. Results depend on individual patient circumstances and can vary significantly. Results may also be impacted by a variety of factors including your lifestyle, weight, nutritional intake and overall health. Consult your Specialist Plastic Surgeon for details. This information is general in nature and is not intended to be medical advice nor does it constitute a doctor-patient relationship. Surgery risks and complications will be covered in detail during a consultation with your Surgeon. We recommend seeking a second opinion from an appropriately qualified medical practitioner before proceeding with surgery.

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