PDFgear lets you edit existing images or add new ones to your PDF.
Open PDFgear and load the PDF with the image you want to edit. Go to the Edit tab and select Edit Text & Image. This activates the image editing tools.
Select Edit Text and Images
Copy: duplicate the image
Export: save the image separately
Replace: swap the image with another
Rotate: rotate the image at angles
Flip Horizontal / Flip Vertical: mirror the image
Crop: trim the image to keep only the needed area
Arrange: move the image forward or backward relative to other objects
Delete: remove the image from the page
Edit the Image in PDF
Besides editing existing ones, you can insert new images into your PDF:
Add an Image to PDF