Prof. Alfredo Borriello
Plastic, Aesthetic and Reconstructive Surgery
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Implant Replacement

What is Implant Replacement?

Breast implant replacement is a plastic surgery procedure that removes existing implants and inserts new ones, for aesthetic or medical reasons. Over the years, a patient's needs may change, or tissue modifications may occur that make implant replacement advisable. Although modern implants are designed to last a long time, replacement is a relatively common procedure and less invasive than the initial breast augmentation, as the implant pocket has already been created. The surgeon takes the opportunity to evaluate the tissue condition and optimize the aesthetic result.

How does Implant Replacement work?

The procedure involves removing existing implants through the same incision used in the previous surgery (generally in the inframammary fold), followed by careful evaluation of the implant pocket and surrounding tissues. If necessary, a capsulectomy is performed — the partial or total removal of the fibrous capsule that the body naturally forms around the implant. New implants are then inserted, potentially of different size, shape, or profile from the previous ones. In some cases, the surgeon may change the placement plane (for example, from subglandular to dual plane) to improve the aesthetic result.

What types of Implant Replacement are there?

Replacement may be necessary for various reasons, and the type of procedure is adapted to the specific situation: • Elective replacement: to change size (increase or decrease volume), shape (from round to anatomical or vice versa), or profile of implants based on the patient's new aesthetic preferences • Replacement for capsular contracture: when the fibrous capsule around the implant thickens and contracts, causing hardening, pain, and breast deformation. Requires associated capsulectomy • Replacement for rupture: in case of confirmed or suspected implant damage, diagnosed via ultrasound or MRI • Replacement with mastopexy: when, in addition to implant replacement, a breast lift is also needed to correct ptosis that has developed over time

Implant replacement is recommended in the following situations: • Aging implants placed over 10-15 years ago, even in the absence of symptoms, when check-ups reveal signs of wear • Capsular contracture with breast hardening, pain, or deformation • Rupture or suspected implant rupture diagnosed through imaging (ultrasound or breast MRI) • Desire to change implant size or shape to adapt to new aesthetic needs or body changes • Aesthetic dissatisfaction with the result of the previous procedure • Implant malposition (displacement, rotation of anatomical implants) • Visible rippling (implant undulations visible through the skin)

The procedure is not recommended in the following cases: • Ongoing pregnancy or breastfeeding, for the same reasons that contraindicate any breast surgery during this phase • Active infections, both local (in the breast area) and systemic, which would significantly increase the risk of complications • Uncontrolled coagulation disorders • General health conditions that make surgery under general anesthesia inadvisable

How long does the procedure take?

The procedure takes 1-2 hours for a simple replacement, but may require longer (2-3 hours) if combined with capsulectomy or mastopexy. It is generally performed as day surgery, allowing the patient to return home the same day. Recovery requires 1-2 weeks and is generally faster and less painful than the initial procedure, as the tissues are already adapted to the presence of implants. A support bra must be worn for 3-4 weeks. Light daily activities can resume after a few days, while sports should be avoided for at least 3-4 weeks.

Is anesthesia required?

Yes, implant replacement is performed under general anesthesia to ensure maximum patient comfort and allow the surgeon to work with the necessary precision, especially when capsulectomy or implant repositioning is required. As with all procedures under general anesthesia, a preliminary anesthesiology consultation with preoperative tests is performed to verify the patient's suitability.

When are the results visible?

Results are visible immediately after surgery, with the breasts assuming their new shape and size right away. Post-operative swelling is generally less pronounced than with the first procedure. Final results are appreciated after 2-3 months, when the new implants have settled in the pocket, swelling has completely resolved, and tissues have adapted. If mastopexy was also performed, stabilization times may be slightly longer (3-4 months).

How often should implants be replaced?

Modern cohesive silicone breast implants do not have a predetermined expiration date and can last a long time without needing replacement. The old concept that implants should be changed every 10 years is no longer valid. However, an annual ultrasound check-up is recommended starting from the tenth year after implantation, to monitor the condition of the implant shell and the periprosthetic capsule. Replacement becomes necessary only in case of complications (capsular contracture, rupture) or patient aesthetic desires. In the absence of problems, implants can remain in place for many years.

Real cases treated by Dr. Borriello
What patients say
MARIA GAUDINO
Il Dottor Borriello è un medico e professore di grandissima professionalità e umanità. Mi sono affidata a lui per il mio secondo intervento, dopo aver avuto un problema con le protesi (problema che, ci tengo a precisare, è stato causato da me e non dal medico), e posso dire con il cuore che è stata la scelta migliore che potessi fare. Oltre ad essere un eccellente chirurgo estetico, il Dottor Borriello è anche un medico esperto nella ricostruzione della mammella, un ambito in cui dimostra competenza, delicatezza e grande sensibilità. Quello che lo distingue è il suo approccio umano: non guarda solo l’estetica, ma mette sempre al primo posto la salute, l’equilibrio e il benessere psicologico delle sue pazienti. Ti segue con attenzione, ti ascolta e ti accompagna con gentilezza e professionalità in ogni fase del percorso. Un professionista straordinario e una persona vera, che unisce talento, cuore e profonda dedizione al suo lavoro.
ottobre 2025
elvy lande
Il Dottor Borriello non è solo un'eccellente medico chirurgo nel campo della chirurgia estetica , ma è anche un uomo dotato di grande umanità, delicatezza e sensibilità. Nel mio caso specifico, ha provveduto all'asportazione delle protesi mammarie di cui una era rotta in seguito ad una mammografia nn eseguita correttamente in altra sede. Il Dottor Borriello ha eseguito un intervento certosino, ridandomi sicurezza e fiducia in me stessa, lo consiglio vivamente a chi volesse intraprendere un intervento in una delle varie discipline del mondo della chirurgia estetica. Va ben oltre le 5 stelle x la sua professionalità.
settembre 2025
Loredana Aversano
Mi sono operata con il dottor Borriello da appena tre mesi per una sostituzione protesi…ancora nn credo al fatto di nn avere sofferto ed è venuto fuori un capolavoro!! Lui estremamente professionale, mi ha messa subito a mio agio ed io giorno dell intervento è stato molto sensibile vista L agitazione mia!! Ancora oggi mi segue nel post operatorio ed io lo rifarei domattina se fosse necessario!!! Borriello una garanzia!!!!
giugno 2025

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Prof. Alfredo Borriello
Plastic, Aesthetic and Reconstructive Surgery
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Viale Antonio Gramsci 30, Napoli
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