Implant Exchange




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    Breast Implant Exchange in Atlanta, GA

    Breast implants are a safe and popular choice for women who want to have larger breasts or differently shaped breasts. But breast implants do not last forever. They need to be replaced for various reasons due to aging, desire for a breast size or shape change, or treatment of capsular contracture. Part of the process of having breast implants requires exchanging them at some point in the future.

    What is breast implant exchange?

    Breast implant exchange is a common cosmetic surgery performed to exchange silicone gel or saline implants with new implants. At the time of the implant exchange patients have the option to maintain their same breast size, or increase or reduce breast size. In my practice, a common time for breast implant exchange is between 12-15 years after the initial surgery. It is not recommended to wait to have “problems” with the implant to exchange them, because the exchange surgery can become very complex and the recovery more intense when we have to treat breast implant problems, such as rupture, capsular contracture, or severe malpositioning.

    What is simultaneous implant exchange with fat?

    Patients may choose to replace their implants with a fat transfer procedure, a good choice for patients who want a mild improvement in the natural breast size. Fat is removed with liposuction from any body part with fatty deposits (the abdomen, legs, or arms) and is transferred with special cannulas to the areas of the breast we want to treat.

    What is saline to silicone implant exchange?

    Patients with older breast augmentations using saline implants may decide to switch to newer silicone gel implants at the time of exchange. Silicone implants are safe and can have a more natural feel.

    How is a breast implant exchange surgery performed?

    Breast implant exchange surgery is performed under local anesthesia and sedation or general anesthesia depending on the type of procedure. The procedure takes about 2 hours to complete. It can take longer if a breast lift is also necessary to reshape the breasts. We start with incisions at the original implant incision location if possible. The breast implants are removed and the capsule supporting the implant is either removed, or if healthy it is left in place and it can help support the breast. We insert the new implant and make the necessary adjustments for shape and symmetry. We close the skin with sutures, the patient stays about an hour in the recovery room and then can go home.

    An implant exchange can also be performed at the same time as other procedures of the breast and body such as a breast lift, a fat transfer, or a tummy tuck (abdominoplasty).


    If you think you are interested in an implant exchange, we can meet at my office to discuss the procedure details and your options.
    -Dr. Gabriele Miotto


    Do I need to be sedated during breast implant exchange surgery?

    Most of the time, the procedure can be performed under general anesthesia. Anesthesia options are discussed with the patient and the anesthesiologist once the type of procedure is decided on.

    Will there be a visible implant exchange scar after surgery?

    In general, the incisions are very fine and when well healed should not be noticeable. The incisions are usually made at the original breast augmentation incision site, around the areola or under the breast fold.

    Will there be swelling after implant exchange surgery?

    Yes, there will be some bruising and swelling after the surgery for about 2-3 weeks.

    What is breast implant exchange recovery time?

    The average downtime is about 2 weeks after the procedure. Some patients have more swelling or bruising than others, so it may take about 3 weeks for the most visible signs of surgery to be gone.

    Am I a good candidate for implant exchange?

    If you are in good health, you may be a good candidate for breast implant exchange if you want to replace old implants, either to keep the same breast size, or if you want larger or smaller implants. We can also decide to replace your saline implants with silicone gel, or vice-versa.

    What does the breast implant exchange cost?

    There are several factors that make up the cost of breast implant exchange surgery. It varies depending on the goals of the patient, the complexity of the procedure, the type of implants used, and the need for a breast lift with the implant exchange.

    How can I get started to learn more?

    If you think you are interested in having an implant exchange, it would be my pleasure to see you in the office for an in-person consultation. We can talk about what you want to achieve, size expectations, need for a lift or just the implant exchange, and go over the specific areas you are looking to improve.

    After the breast implant exchange procedure

    Breast implant exchange is an outpatient surgery done under general anesthesia. After the procedure, there will be visible fine skin sutures in the incisions, some bruising and swelling.

    Breast implant exchange is not a painful procedure, but mild discomfort and feeling of tightness in the operated area is expected for a few days to a few weeks after surgery. Bruising and swelling are usually the cause of the discomfort. However, it can be treated with preoperative and postoperative medication and supplementation, ice and anti-inflammatories. Swelling can be minimal or more intense depending on how many procedures need to be done in surgery to make the results the most beautiful and natural possible.

    Sutures are removed between 10-15 days after the surgery if needed. Return to normal daily activities between 2-3 weeks. Expect at least 4 weeks for committing to major social events as residual swelling can remain for some patients after surgery. We are all different, so it is hard to predict who will get more or less swelling and bruising.

    General preoperative recommendations for implant exchange surgery:

    What to avoid before surgery:

    1. DO NOT take any aspirin for 7-10 days before your scheduled procedure. Do not take NSAIDS (Aleve, Motrin, Ibuprofen) for 5 days before surgery. You may take Tylenol (Acetaminophen) if needed for aches or pains. Please contact the office at if you have any questions about any medications that you are taking or if you are prescribed aspirin by your cardiologist or Primary Care Provider (PCP).
    2. Discontinue Vitamin E 10 days before surgery.
    3. Avoid the following herbal supplements for 10 days before surgery: Echinacea, Ephedra / Phentermine (used for weight loss), Feverfew, Fish Oils, Garlic, Ginkgo Biloba, Goldenseal, Kava-Kava, Licorice, Saw Palmetto, St. John’s Wort and Valerian.
    4. Stop Smoking. The harmful effects of smoking can cause tissue death, infection, and open wounds. It also makes you age faster!
    5. Alcohol can promote swelling of the surgical area and it is best to avoid alcohol intake for at least one week before surgery.

    What to take before surgery:

    1. Dr Miotto will instruct you to begin using medications and supplements to help speed up healing when you come in for your preoperative visit.

    General postoperative recommendations after implant exchange surgery:

    1. You MUST have a responsible adult to transport you home and stay with you for a full twenty-four hours after your surgery.
    2. You will be unable to drive if you are taking narcotics.
    3. It is common to feel sluggish for a few days as the anesthesia works its way out of your system.
    4. It is recommended to elevate the head with two to three pillows after all facial procedures.
    5. Your initial post-operative appointment will be scheduled by your Patient Care Coordinator.


    1. For your safety, we require that you have a responsible adult stay with you for twenty-four hours after your surgery for general help, as you may find your balance and judgement impaired.
    2. Please refrain from physical activity that will increase your heart rate or blood pressure for 2 weeks after surgery. However, bed rest is NOT recommended, and you should be walking at normal pace after the procedure.
    3. Frequent walking will decrease the risk of post-operative blood clots (mostly after general anesthesia).
    4. Sexual activity can safely be resumed 2 weeks following surgery. Please discuss with Dr Miotto as needed.


    1. You can shower twenty-four hours after surgery. You may clean the incisions as instructed by Dr Miotto or her nurses after the procedure.
    2. Do not submerge yourself into a tub/pool until all wounds have healed (usually in 3 weeks).
    3. Do not scrub the surgical sites, however you can allow soapy water to run over them.
    4. Avoid lotions on the surgical sites for 2 weeks, but you can moisturize any other areas as desired.

    Returning to Work:

    1. Recovery time will vary; however, most patients return to work within one to 2 weeks after the procedure, within one week you will have a feel for your specific limitations and will be able to determine how comfortable you will be with resuming your daily activities and workload.


    1. Immediately following surgery, it is best to eat bland, easily-digested food and avoid excess sugar and salt. Healthy proteins (eggs, lean meat, beans, nuts), rice, fruits and cooked vegetables (broccoli, peppers, sweet potatoes) will provide your body with nutrients essential for healing.
    2. Eat a few bites of food before taking pain medications as these can cause nausea.
    3. A diet low in sodium will help minimize swelling and water retention.
    4. Drink plenty of water! Drinking low sugar sports drinks and protein shakes are recommended.

    Final Results:

    1. Keep in mind that our goal in aesthetic surgery is improvement and not perfection. You will be followed closely after surgery to assure that you heal well and have the best possible results.
    2. It can take months for the very final results of your surgery be apparent. After 12 weeks, you can expect your results to be mostly permanent. Expect subtle changes in swelling and healing (including the appearance of scarring) to continue to appear for up to twelve months.
    3. It is important for you to keep open communication with your physician and return for your follow up visits. We will take pre and post pictures along the way and look at the final results together.

    GABRIELE C. MIOTTO MD, MEd., is a Brazillian-American plastic surgeon specialized in aesthetic surgery and minimally invasive procedures, specially of the face, eyes, nose, breast and liposuction. Call 404-850-5851 for your consultation.



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