Beverly Hills Plastic Surgeon Dr. David Sayah Reports Growing Demand for Breast Implant Removal and BBL Reversal

For decades, many cosmetic surgery trends focused on adding volume. Beverly Hills board-certified plastic surgeon David Sayah, MD, FACS, says he is seeing a notable shift within his own practice: more patients are coming to him seeking to reverse or revise previous augmentation procedures and return to more natural proportions. Dr. Sayah says breast implant removal , breast revision surgery and buttock reduction are now a regular part of his Beverly Hills surgical practice as more patients seek to restore proportion after previous augmentation. The shift is particularly noteworthy because national breast implant removal statistics have remained relatively stable. According to the American Society of Plastic Surgeons' 2024 Plastic Surgery Statistics Report, 41,271 breast implant removal procedures were performed among augmentation patients in 2024, compared with 41,115 in 2023. "The totals haven't moved dramatically, but the conversations I'm having with patients have," said Dr. Sayah. "Years ago, many consultations began with a discussion about how much volume a patient wanted to add. Today, I increasingly meet patients who want to remove an implant, reduce previous augmentation or restore a more natural proportion. That can be a much more complex surgical problem." Restoring Shape After Breast Implant Removal For patients seeking breast implant removal, removing the implant itself may be only one component of treatment. Years of augmentation can affect the breast skin, soft tissue and overall shape. Depending on the patient's anatomy, tissue quality and aesthetic goals, additional procedures may be considered to restore breast position, volume and proportion. One option for appropriately selected patients is autologous fat grafting, which uses fat harvested from another area of the patient's own body to restore volume without placing another breast implant. "The goal isn't simply to take something out," Dr. Sayah said. "The more difficult question is how to restore shape and proportion afterward. Sometimes that may involve a breast lift, sometimes fat grafting, and sometimes a combination of techniques tailored to the individual patient." The approach reflects Dr. Sayah's broader philosophy of plastic surgery, which emphasizes proportion and individualized results rather than treating size or volume as the primary measure of a successful outcome. BBL Reversal and Buttock Reduction Emerge as Revision Concerns A similar issue is emerging among patients who previously underwent Brazilian butt lift procedures or other forms of buttock augmentation and now feel their results are too large or disproportionate to the rest of their body. BBL reversal and buttock reduction have become recognized areas of revision body contouring. A 2025 study published in Aesthetic Surgery Journal Open Forum reviewed 123 patients who underwent BBL revision or buttock reduction between 2018 and 2023. The authors described BBL revision and buttock reduction as an increasingly popular area of body contouring and predicted continued growth in demand for these procedures. Dr. Sayah continues to perform buttock augmentation for appropriately selected patients but believes the objective should be balanced proportion rather than augmentation for its own sake. "I still perform fat grafting and buttock augmentation, but the goal should be a result that fits the patient's frame," Dr. Sayah said. "Understanding how these procedures are performed also provides important perspective when evaluating someone who later wants an exaggerated result reduced or revised." Depending on the patient's previous procedure, anatomy and goals, revision may involve reducing excess fat, contouring...