Breast implants are durable, but sometimes an exchange makes sense: for capsular contracture, a defect or the wish for a different size. The exchange is usually carried out through the existing scar – combined with a breast lift if desired.
2–3hours for the procedure, under general anaesthesia
1–2nights in the clinic
1–2weeks until you return to everyday life
4–6weeks in a support bra, sport only after medical clearance
Typical figures from the clinics; with capsule removal or a lift, it may take longer. Your personal plan is discussed at the preliminary consultation.
The exchange
When an implant is to be replaced.
The body forms a thin capsule of connective tissue around every implant – this is normal. If it hardens and shrinks, this is known as capsular contracture: the breast feels firm, may hurt and can change shape. It is the main reason for an exchange on medical grounds.
Other reasons include a defect in the implant shell, an infection, a displaced or rotated implant, or older implants that are now considered a cause for concern. Often the reason is aesthetic: after pregnancy, weight loss or over the years the breasts drop, or the size once chosen no longer feels right.
There is no fixed date for an exchange. As long as there are no symptoms or findings, modern implants can stay in place for a long time. However, any new hardening, swelling or fluid around the implant should be checked by a doctor – even years after the operation.
The treatment
What an exchange can achieve.
Treating symptoms
With capsular contracture, the hardened capsule is removed as well, so that the new implant can sit in healthy tissue.
Adjusting the shape
Size, shape and position can be chosen anew – including a move from above the chest muscle to partly beneath it.
Lifting and refining
If the breast has dropped, the skin can be tightened in the same procedure; fat transfer can make the transitions softer.
An exchange takes longer than the first operation because the old implant, and often the capsule too, is removed. In surgical terms it is comparable to the first implantation.
Assessment
The specialist examines the breasts, asks about the manufacturer and age of the implants and arranges an ultrasound or MRI scan if needed. The implant passport and earlier surgical reports are helpful.
Planning
The decision is made together: the same or a new size, a different shape or position, an additional lift or fat transfer – or removal without a new implant.
Surgery
Under general anaesthesia, the implant pocket is usually opened through the existing scar. The old implant is removed – with capsular contracture together with the capsule, sometimes both in one piece (en bloc).
New implant
The new implant is inserted, in a new pocket if necessary. Without a lift there are usually no new scars; with a lift, the incisions follow the lift.
Recovery
One to two nights in the clinic. In the first few days, a feeling of tightness, bruising and restricted arm movement are normal; a support bra and rest help the healing process.
Check-ups
Regular check-ups accompany the new implant too, with ultrasound or MRI if needed.
Statutory insurance or self-pay
Who covers the costs.
With capsular contracture
Statutory cover in individual cases.
If capsular contracture causes symptoms, the exchange is a medical treatment. In individual cases it may then be covered by German statutory health insurance; whether the requirements are met is checked before the operation.
If the first operation was performed for purely aesthetic reasons, statutory insurers require patients to pay a reasonable share of the costs under § 52 SGB V (German Social Code, Book V). For privately insured patients, the terms of the policy decide; complications insurance taken out at the time of the first procedure may step in, depending on the contract.
If the costs are covered, the operation takes place at the Bürgerspital Wertheim; pre- and post-operative care remain close to home.
For aesthetic reasons
A self-pay treatment.
Anyone who wants to change size or shape, or who has implants exchanged without symptoms, pays the costs themselves. They depend on whether the capsule is removed, whether a lift is added and which implant is chosen.
You receive a personal quote after the preliminary consultation; several clinics offer financing in instalments.
Specialists
Your surgeons at a glance.
Operations are performed by specialists in plastic and aesthetic surgery. Under each name you will find the locations where they exchange implants.
Dr. med. Karina BaierSpecialist in Plastic and Aesthetic SurgeryHamburg
Dr. med. Michael BrombaSpecialist in Plastic and Aesthetic SurgeryDortmund · Düsseldorf · Wertheim
Dr. med. Katharina Dette-OltmannSpecialist in Plastic and Aesthetic SurgeryHamburg
Dr. med. Frank GrunerSpecialist in Plastic and Aesthetic SurgeryDortmund · Düsseldorf
Dr. med. Uwe HerrboldtSpecialist in Plastic and Aesthetic SurgeryDortmund · Wertheim
Dr. med. Stephan KlarnerSpecialist in Plastic and Aesthetic SurgeryHamburg
Dr. med. J. Philipp NeisSpecialist in Plastic and Aesthetic SurgeryHamburg
Dr. med. Martin ReifenrathSpecialist in Plastic and Aesthetic SurgeryDortmund · Wertheim
Dr. med. Cornelius SchubertSpecialist in Plastic and Aesthetic SurgeryHamburg
Dr. med. Maria SimidjiiskaSpecialist in Plastic and Aesthetic SurgeryDortmund · Wertheim
Prof. Dr. med. Mathias WittSpecialist in Plastic and Aesthetic SurgeryDortmund · Düsseldorf · Wertheim
Dr. med. univ. Nura ZamaniSpecialist in Plastic and Aesthetic SurgeryDortmund
Locations
Where treatment takes place.
Each clinic shows on its own website how the treatment works there.
Germany
Dortmund
Specialist clinic for plastic and aesthetic surgery at the group’s headquarters, with inpatient stays of one to two nights.
The Bürgerspital and the Main-Tauber-Klinik under one roof: exchanges covered by insurance are performed at the Bürgerspital, self-pay procedures at the private clinic.
When symptoms or findings occur: hardening, pain, a change in shape, a suspected defect or a change in position. Without such signs there is no fixed date; the decision is made after examination and imaging.
What is capsular contracture?
A hardening and shrinking of the connective tissue capsule that the body forms around every implant. It is classified into four Baker grades; in the higher grades the breast feels hard, hurts or becomes misshapen. It is usually treated by removing and replacing the capsule and implant.
Can capsular contracture come back?
Yes. A capsule also forms around the new implant, and it can harden again. Removing the old capsule, creating a new pocket and choosing a suitable implant are intended to reduce the risk; it cannot be ruled out.
Will there be new scars?
Usually not. The exchange is generally carried out through the existing scar. If a lift is added, the incisions follow the lift.
Can I simply have the implants removed?
Yes. Whether the breasts keep their shape afterwards depends on the skin and tissue. Removal is often combined with a lift or fat transfer; the preliminary consultation clarifies which options are suitable.
Are older implants a risk?
That depends on the model. Some older implants, such as those filled with soya oil, or certain textured surfaces are now regarded as a reason to consider an exchange. If you do not know the manufacturer and model, have a doctor identify them – the implant passport helps.
Can I change the size during the exchange?
Yes – larger, smaller or a different shape. A significant reduction often requires a lift so that the skin can adapt to the smaller shape.
Does health insurance pay for the exchange?
With capsular contracture that causes symptoms, German statutory health insurance may cover the exchange in individual cases; the operation then takes place at the Bürgerspital Wertheim, while pre- and post-operative care remain close to home. An exchange for aesthetic reasons is a self-pay treatment.
Choose a location, pick your preferred date. You confirm with a code sent by text message or e-mail; the appointment is booked directly in the clinic's calendar.
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This was the best decision I have ever taken for myself. The whole experience has changed my life for the better. From the first consultation I felt welcomed and treated very well. I did not feel alone during the journey because the team were just a WhatsApp away and they made regular check-ups on me. Thank you for everyone at the hospital from the staff to the doctors, you are all amazing.
Weight Doctors South Africa
MMaria
Wow, was für ein erster Eindruck! Dr. Frank Gruner, dessen Professionalität von jahrelanger Erfahrung zeugt, war äußerst verständlich und menschlich (was mir sehr wichtig war). Er verstand meine Bedürfnisse, und seine Erklärungen und Anweisungen entsprachen genau meinen Vorstellungen. Die Patientenberaterin Jennifer war mit ihrem Charme ebenfalls eine große Hilfe und erklärte mir alles Notwendige und den weiteren Ablauf. Auch die Mitarbeiter am Empfang waren sehr höflich und freundlich. Ich melde mich nach der Operation mit meinen Eindrücken zurück. Vielen Dank an alle!
Westfalenklinik Fachklinik für Plastische und Ästhetische Chirurgie · Original in German
AAnonym
Ich habe eine Unterlidstraffung machen lassen und bin mit dem Ergebnis sehr zufrieden. Mein Dank geht vor allem an Frau Dr. Simidjiiska für ihre Fürsorge, Kompetenz und Empathie. Aber auch das gesamte Team der Klinik macht einen hervorragenden Job!
Westfalenklinik Fachklinik für Plastische und Ästhetische Chirurgie · Original in German
AAnonym
Ich bin rundum begeistert von meiner Erfahrung in dieser Haartransplantationsklinik. Von der ersten Kontaktaufnahme bis zur Nachsorge war alles hervorragend organisiert und professionell. Das gesamte Team war unglaublich freundlich, hilfsbereit und zuvorkommend. Man hat sich jederzeit gut aufgehoben und ernst genommen gefühlt. Besonders positiv fand ich, dass sich alle Mitarbeiter ausreichend Zeit genommen haben, um meine Fragen zu beantworten und jeden Schritt verständlich zu erklären. Auch der Service war erstklassig. Die Organisation, die Betreuung vor und nach dem Eingriff sowie die Kommunikation waren wirklich hervorragend. Das gesamte Team hat einen sehr kompetenten und gleichzeitig menschlichen Eindruck gemacht. Die Klinik selbst ist modern, sauber und sehr gut ausgestattet. Während der Behandlung wurde äußerst sorgfältig und professionell gearbeitet, und ich hatte zu jedem Zeitpunkt das Gefühl, in guten Händen zu sein. Ein großes Dankeschön an das gesamte Team für die tolle Betreuung und den freundlichen Umgang! Ich kann die Klinik absolut weiterempfehlen und bin mit meiner bisherigen Erfahrung sehr zufrieden. Wer Wert auf Professionalität, Qualität und einen hervorragenden Service legt, ist hier meiner Meinung nach bestens aufgehoben.
Westfalenklinik Fachklinik für Plastische und Ästhetische Chirurgie · Original in German
AWAndre W.
Bisher war es nur ein Beratungsgespräch aber es war sehr gut.
Weight Doctors Group · Original in German
DCDavid C.
Ich fand, dass der Arzt gut und verständlich erklärt hat. Ich habe diese Woche noch einen Termin in einer anderen Klinik, da ich mich gründlich informieren möchte; auch der Preis wird dabei eine Rolle spielen – darüber bin ich ganz offen.
QUOLE Medisch Centrum · Original in German
MMomo
Hervorragende Behandlung. Von der ersten Beratung bis zur Nachsorge hat mir Dr. Koch stets ein sehr gutes Gefühl vermittelt. Ich litt jahrelang unter einer echten Gynäkomastie, nach der OP kann sich das Ergebnis sehen lassen, mein Selbstbewusstsein ist endlich zurückgekehrt. Ich kann die Alster Klinik jedem empfehlen, der schon lange mit dem Gedanken spielt sich operieren zu lassen.
Alster-Klinik Hamburg · Original in German
AAnonym
Dr. Schubert gab mir das Gefühl, in genau der richtigen Praxis zu sein für mein Anliegen. Ich habe mich beim Beratungsgespräch sehr wohl gefühlt und verstanden gefühlt.
Alster-Klinik Hamburg · Original in German
LSLieselotte S.
Über die ehrliche Einschätzung
Alster-Klinik Hamburg · Original in German
HGHannelore G.
Ich habe mich sehr wohl geführt, das Gespräch war sehr gut, die Ärztin hat mir sehr ausführlich alles erklärt und bin mit einem sehr guten Gefühl nach Hause gegangen.
Westfalenklinik Fachklinik für Plastische und Ästhetische Chirurgie · Original in German
CKCarmen K.
Ich bin eine sehr ängstliche Person. Bei Herrn Dr. Neis habe ich mich sofort wohlgefühlt. Behandlungsgespräche, Umgang, Freundlichkeit – es passt alles. Ich kann ihn ohne Bedenken und Einschränkung nur weiter empfehlen. Dankeschön Herr Dr. Neis für die tolle Arbeit.
CGCE Group · Original in German
MLMichaela L.
Dr. Klarner ist sehr nett, hat mich sehr gut beraten und aufgeklärt. Ich hab mich gut aufgehoben gefühlt, vielen Dank!
Dr. med. Karina Baier
Dr. med. Michael Bromba
Dr. med. Katharina Dette-Oltmann
Dr. med. Frank Gruner
Dr. med. Uwe Herrboldt
Dr. med. Stephan Klarner
Dr. med. J. Philipp Neis
Dr. med. Martin Reifenrath
Dr. med. Cornelius Schubert
Dr. med. Maria Simidjiiska
Prof. Dr. med. Mathias Witt
Dr. med. univ. Nura Zamani
