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

Board-certified plastic surgeon says more patients are seeking revision procedures focused on restoring natural proportions through breast implant removal, buttock reduction and autologous fat grafting

BEVERLY HILLS, Calif., Sept. 11, 2026 /PRNewswire/ -- 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 surrounding areas, addressing skin laxity or combining techniques to create more balanced proportions.

A Broader Return to Natural Proportions

Dr. Sayah believes the patients he sees for breast implant removal and BBL reversal reflect a broader change in the conversation surrounding cosmetic surgery. Rather than asking primarily how much volume can be added, some patients are now asking how previous augmentation can be reduced or revised while preserving an attractive, natural-looking shape.

Autologous fat grafting can play a role in that approach because it allows a surgeon to use the patient's own tissue to refine contour or restore volume where appropriate.

For breast revision patients, that can mean removing an implant and selectively restoring volume with the patient's own fat. In body contouring, it can mean reducing areas that have become disproportionately large while reshaping surrounding areas to create better balance.

"In many of these consultations, the conversation is no longer about becoming larger," Dr. Sayah said. "It's about getting back to a shape that feels natural and proportionate to the patient's body."

Reversal Surgery Is Not a Return to the Past

Dr. Sayah cautions that reversal surgery cannot simply recreate a patient's appearance before the original augmentation. Skin and soft tissue may have changed after years of carrying additional volume, and the amount of transferred fat that is retained can vary among patients.

For that reason, treatment must be individualized, and some patients may require more than one procedure to achieve their desired result.

"The honest goal is proportion, not turning back the clock," Dr. Sayah said. "Revision surgery requires understanding what has changed anatomically and developing a realistic plan for restoring balance."

About David Sayah, MD, FACS

David Sayah, MD, FACS, is a board-certified plastic surgeon and Fellow of the American College of Surgeons practicing in Beverly Hills, California. With more than 26 years of experience, Dr. Sayah specializes in aesthetic and reconstructive plastic surgery with an emphasis on natural proportions and minimizing visible scarring.

A graduate of the UCLA School of Medicine, Dr. Sayah completed his plastic surgery residency at UCLA Medical Center and received an additional year of advanced training in endoscopic plastic surgery under Dr. Nicanor Isse, a pioneer in the field. Dr. Sayah and Dr. Isse co-authored a chapter on endoscopic facelift and brow lift techniques in The Art of Aesthetic Surgery, and Dr. Sayah has taught endoscopic surgical techniques to other surgeons in courses across the country.

Dr. Sayah's approach combines surgical training with a background in fine arts, proportion and form, with the goal of creating individualized results that complement each patient's natural anatomy.

The Sayah Institute is located at 436 North Bedford Drive, Suite 202, Beverly Hills, CA 90210. The office is open Monday through Friday from 9:00 AM to 5:00 PM. For more information or to schedule a consultation, call (310) 385-0000 or visit www.drsayah.com.

Media Contact
Dr. David Sayah
The Sayah Institute
(310) 385-0000
https://www.drsayah.com

SOURCE The Sayah Institute