Breast revision and breast implant removal are separate procedures with distinct objectives and meaningfully different outcomes. Some women want a different result from their augmentation; others are done with implants entirely. Where a patient stands on that question determines the entire surgical direction.
Dr. Steven Teitelbaum, Associate Clinical Professor of Plastic Surgery at UCLA and past president of the California Society of Plastic Surgeons, has practiced exclusively in aesthetic surgery in Santa Monica since 1995. In this blog, Dr. Teitelbaum draws on his surgical experience to walk through what each procedure involves and what factors should guide the decision.
What Is Breast Revision Surgery?
Breast revision covers any secondary surgery that modifies, exchanges, or repositions existing implants, with the goal of correcting or refining what the original procedure produced. Patients pursue revision for a range of reasons:
- Size or profile change to reflect updated aesthetic goals or physical changes
- Implant exchange, such as switching from saline to silicone or choosing a different implant generation
- Correcting malposition, including bottoming out or lateral displacement
- Capsular contracture causing firmness, distortion, or discomfort
The risks and considerations specific to revision procedures differ from those of primary augmentation, and the technical scope can vary considerably. Surgeon experience with secondary breast surgery is a meaningful factor in the outcome.
What Is Breast Implant Removal (Explant) Surgery?
Explant surgery removes the implants permanently. Some patients choose no replacement; others add fat transfer or a lift at the same time. The procedure often includes a capsulectomy, which removes the scar tissue capsule that naturally forms around every implant.
In cases of confirmed breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), en bloc capsulectomy is generally recommended. This technique removes the implant and its surrounding capsule together as a single unit, a more extensive dissection than implant removal alone. For other complications such as rupture, the approach to capsule removal is determined case by case and should be discussed with the surgeon.
Breast Revision vs. Implant Removal: Key Differences
The two procedures share incision sites and a comparable initial recovery period, but their objectives diverge, shaping the entire surgical plan. A side-by-side comparison:
- Goal: Revision preserves or updates breast volume; explant removes it, with or without reconstruction through fat transfer
- What happens to the implant: Revision involves exchange or repositioning; explant removes it permanently
- Typical candidates: Revision suits patients who want implants but a different result; explant suits those who no longer want implants or have a medical reason for removal
- Recovery: Initial downtime is comparable in both; en bloc capsulectomy may extend the timeline depending on the extent of capsule involvement
According to the American Society of Plastic Surgeons, the national average surgeon fee for breast implant removal reached $3,979 in 2023, up from $3,437 in 2022. Breast augmentation procedures, which include revision implant placements, averaged $4,875 nationally that same year. Both figures reflect surgeon fees only; facility and anesthesia costs are not included.
How to Decide Which Procedure Is Right for You
The clearest starting point is a single question: Do you still want breast implants? Most patients arrive at this crossroads because of a specific complication. The FDA identifies capsular contracture, malposition, and rupture as the issues most commonly driving the revision-or-removal decision, and in each case the right answer depends on the nature of the complication and what the patient ultimately wants.
When Revision Makes More Sense
Revision tends to be the stronger fit when a patient wants to keep implants but is unhappy with the current outcome. Common scenarios include:
- A size or projection that no longer reflects the patient's body or preferences
- Malposition that is surgically correctable
- Capsular contracture without other complicating factors
- Desire to switch implant type, profile, or generation
When Removal Makes More Sense
Some situations point more clearly toward explant. Removal may be the better path when:
- The patient no longer wants implants, with no medical complication required to justify that decision
- A silicone implant has ruptured and gel migration is a concern
- BIA-ALCL has been diagnosed; implant and capsule removal is typically the primary treatment
- Symptoms consistent with breast implant illness are the primary driver
- Chronic complications have persisted despite prior intervention
Neither decision should be reached quickly. The right procedure is the one that actually addresses the problem, and it should not be settled without thorough consultation and an honest discussion of what each option can and cannot achieve.
Plan Your Next Step with Dr. Teitelbaum
For patients in the Los Angeles area, Dr. Teitelbaum brings the surgical depth and research-informed perspective this kind of decision demands. He has lectured on five continents, contributed to multiple research trials, and devoted his Santa Monica practice exclusively to aesthetic plastic surgery since 1995. Patients leave his consultations knowing their options and what to expect from each one.
To discuss whether revision or removal is right for your situation, contact Dr. Teitelbaum's Santa Monica office to schedule a consultation.
