NP Aesthetics
Breast implant replacement in Zurich
In an implant replacement, an existing implant is removed and replaced with a new one — often combined with a correction of the implant pocket, the capsule or the tissue position. Reasons include symptoms, changes in shape or position, an implant defect or a changed desired outcome. The timing follows from the findings, not from the age of the implant.
Consultations and surgery are performed by Dr. med. Michael W. Payne or Dr. med. Dr. Phil. Annemarie Nijboer at Klinik Selnau, Zurich.
Reasons for a replacement
Age alone is not a reason
An implant that causes no symptoms and is unremarkable does not have to be replaced after a certain number of years. The findings and any symptoms are decisive.
A changed size preference
Preferences change. Both a reduction and an increase are possible, each limited by the skin envelope, tissue thickness and breast width.
A changed breast shape
Tissue and skin change over the years. The implant stays the same; its surroundings do not — this can produce changes in shape that make an adjustment advisable.
Implant displacement
An implant can migrate downwards, sideways or towards the middle. The cause is usually a pocket that is too wide or has weakened.
Capsular contracture
Every body forms a capsule around an implant. If it thickens and shrinks, hardening, changes in shape and sometimes pain result. The extent and the approach are assessed individually.
Implant defect
A defect can go unnoticed and is often only detected by imaging. If it is suspected, an investigation is arranged.
Rippling
Visible or palpable ripples occur mainly with a thin soft-tissue cover. A change of position, the choice of implant or supplementary fat transfer can improve the findings, but cannot reliably eliminate them.
Asymmetry
Differences between the sides can arise newly or become more pronounced.
After pregnancy or weight loss
Volume and the skin envelope change; the implant may then no longer match the surrounding tissue.
After a previous lift with implants
With combined previous operations, the scar conditions and blood supply must be assessed particularly carefully; the approach is planned correspondingly more conservatively.
Examination and assessment
Implant pocket
The width, boundaries and stability of the pocket are assessed, along with the question of whether a narrowing or a new pocket plane is necessary.
Capsule
The thickness, calcification and hardening of the capsule determine whether it is left in place, partially removed or completely removed.
Implant position
In front of, partly under or under the chest muscle — a change of position may be considered with rippling, displacement or repeated capsular contracture.
Skin and soft-tissue quality
The thickness and elasticity of the soft-tissue cover determine what an implant can carry and conceal.
Previous findings
The implant passport, operation reports and any existing imaging are important for planning.
Possible approaches
Replacement alone
Appropriate with a stable pocket, an unremarkable capsule and a good tissue position.
Replacement with pocket correction
Narrowing, reinforcement or creation of a new pocket in cases of displacement or poorly defined boundaries.
Replacement with a lift
Sensible when the tissue position should be changed in addition to the implant question. The combined procedure is more complex and places greater strain on the blood supply.
Replacement with fat transfer
Can strengthen the soft-tissue cover and conceal transitions. The volume effect is limited and not entirely predictable.
Capsule treatment
Depending on the findings, the capsule is left in place, incised, partially removed or completely removed. Complete removal is a larger procedure with its own risk profile and is not performed as a matter of course.
When removal is the better option
With repeated complications, thin tissue or a changed desired outcome, removal without replacement — with or without a lift — can be the more sustainable solution.
Choosing implants in revision surgery
Size, profile, shape and surface are chosen based on breast width, tissue thickness, skin envelope and the course so far. No manufacturer and no implant type is fundamentally superior; what matters is the fit with the findings.
A larger implant rarely solves a shape problem and places additional strain on skin and tissue.
Anaesthesia and surgery
The procedure is performed under general anaesthesia, usually with a short inpatient stay. The extent and duration depend on whether the capsule, pocket or tissue position are also corrected.
Recovery
A straightforward replacement is often less complicated than the first procedure. If capsule or lifting components are added, recovery is correspondingly longer. Sedentary work is usually possible after about one to two weeks; sport and strength training follow in stages after medical clearance. The final shape develops over several months.
Risks
Recurrent capsular contracture
Capsular contracture can occur again after a replacement; the risk is increased with a corresponding history.
Implant malposition
Displacement or an unsatisfactory position can occur again.
Asymmetry
Differences between the sides may remain or newly appear.
Wound healing
Postoperative bleeding, infection, seroma and wound healing problems are possible; previously operated tissue is more sensitive.
Risk of further revision
Every revision procedure increases the likelihood of further operations over time. Full information is provided in the personal consultation.
Long-term follow-up
Regular check-ups are planned after the procedure. Keep the new implant passport; it documents the manufacturer, type and size.
Costs and personal consultation
The medical consultation for surgical procedures costs CHF 250. If you subsequently book an operation with us, the consultation fee is credited in full against the price of the operation. Following the examination, you will receive an individual cost breakdown that clearly states which services are included.
Frequently asked questions
Do implants have to be replaced after ten years?
No. There is no fixed expiry date, and age alone is not a reason for replacement. However, implants are not lifetime products; regular check-ups and an investigation of any changes are sensible.
Is a larger implant the solution for a sagging breast?
Generally not. A larger implant places additional strain on skin and tissue and can accelerate descent. If the tissue position is the main concern, a lift — alone or combined — is the more obvious consideration.
Does the capsule always have to be completely removed?
No. The approach depends on the findings: an unremarkable capsule can be left in place; thickened or calcified parts are partially or completely removed. Complete capsule removal is a larger procedure with its own risks.
Will an existing asymmetry be fully corrected?
An approximation is possible in many cases; complete symmetry cannot be guaranteed. Differences in tissue thickness, capsule conditions and chest wall shape remain influential.
Treating physicians
- Dr. med. Michael W. Payne
Specialist in Plastic, Reconstructive and Aesthetic Surgery
- Dr. med. Dr. Phil. Annemarie Nijboer
Specialist in Surgery
A good decision begins with a conversation.
The initial consultation is about clarification, not selling. It does not necessarily end with a surgery date — often it brings the realisation that a different approach, or no procedure at all, is the right choice.
The consultation process
- 01
Discussion
We listen to your concerns, medical history, expectations and what you would like to change about your appearance.
- 02
Examination
A careful clinical examination and assessment of your underlying anatomy.
- 03
Options
Possible procedures, alternatives, limitations and risks — explained clearly and without time pressure.
- 04
Time to reflect
You decide in your own time. Any outstanding questions can be addressed in a further consultation.
Request a consultation
Leave your contact details. Our practice team will call you back during practice hours to arrange a consultation at Klinik Selnau.