One of the most common topics of conversation regarding breast implants is their shelf life, or “how long they last.”
For women considering a removal and possible implant replacement, there are several important things to understand in order to make an informed decision.
What is the average duration of implants?
Breast implants are one of the most studied medical devices in history. Over the past fifty years, there have been concerns about implant safety and so much so that they have been taken on and off the market in order to conduct thorough medical research.
The first medical-grade silicone gel implants consisted of a thin shell and gooey gel, and patients were concerned that high rates of rupture and leaking implant material were leading to silicone infiltrating the bloodstream and lymph nodes and contributing to connective tissue diseases and autoimmune conditions.
So, in 1992, the Food and Drug Administration (FDA) pulled silicone gel implants off the market, amid a sea of concerns about their safety.
After 14 years of research in cooperation with the American Society of Plastic Surgeons, silicone implants were reintroduced to the market in 2006 and the FDA issued a warning that breast implants are not life-long devices and may require removal and replacement. Additionally, In the case of silicone implants, the FDA recommends having an MRI every three years or so, but not many women do that because it is often an out-of-pocket expense and not covered by your insurance.
However, there is no allotted amount of time (i.e. 20 years) that we as plastic surgeons recommend removal and replacement of implants. Rather, we recommend proper self-breast exams and consultation with your physician should you feel a change in your breasts. On average, most breast implants last anywhere from 10 – 20 years.
How do I know if my implants need to be removed or replaced?
The following issues may necessitate evaluation and possible breast implant removal.
Hardening (Capsular Contracture):
Some women may experience tightness and hardening of the scar, or breast capsule, around their implant. This may cause the breast to migrate up and toward the armpit and be uncomfortable.
Capsular contracture can occur almost immediately after surgery, or it can develop years and years later. The condition can occur on just one or on both breasts.
Implant Rupture:
In women with saline implants, an implant leak would result in the deflation of the implant as the body absorbs the saline, or saltwater, in approximately 24-48hours after deflation. The breast will look dramatically different.
Women with silicone gel implant rupture may not recognize a change in their breasts. The silicone gel in implants today is much thicker than it had previously been and has a consistency similar to taffy or a gummy bear. These cohesive gels make it difficult to detect a rupture because they tend to stay in place within the breast capsule. Additionally, most women do not experience symptoms with a silent rupture.
However, symptoms that you may have a leak include:
change in breast size and/or shape
pain or tenderness
swelling
changes in the sensation of the breast.
Change in Position:
The effects of time and gravity, as well as fluctuations in weight, may cause stretching and sagging of the breasts.
If you’re bothered by these changes, getting a revision with a mastopexy (breast lift) or breast augmentation replacement may help return your breasts to their previous appearance.
Rippling or Palpability:
Rippling occurs when the implant develops wrinkles or ripples. This is more common with saline implants and may worsen with time.
Palpability refers to the ability to feel the ripples when you touch your breast.
If you see or feel wrinkling in your implant, you may want to consider replacing or removing it.
What about Breast Implant Illness? Breast-Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)? Can implants make you ill?
Breast Implant Illness (BII) is a combination of various systemic symptoms that women have been reporting and believe to be related to their breast implants.
To date, these symptoms have been reported in women with saline, silicone, smooth and textured implants.
I have recently written an article all about BIA-ALCL and encourage you to learn more.
Deciding to remove your implants:
If you are experiencing changes in your breasts or simply desire to have your implants removed, make sure to see a board-certified plastic surgeon in consultation to discuss your surgical options.
It is important to talk to your doctor about what your breast may look like after implant removal. Some women may experience deflation, sagging, or asymmetries of their breast
Because of this, your doctor may recommend a breast revision by replacing your implants with a different type of implant, different size or shape, or in combination with a breast lift.
Additionally, the scar tissue, or breast capsule, may be removed in addition to the removal of your breast implants.
What are the surgery and recovery like?
Most patients have this surgery performed and go home the same day. Recovery time will be dependent on the extent of surgery that is being performed.
Most women are back to light activities 3-5 days after surgery and the gym at about 1 month.
The Bottom Line
Implants are some of the most studied medical devices on the market. At this time, research has continued to argue for their safety.
However, implants are not life-long devices and you may need to have them removed or replaced for a variety of reasons.
The best way to ensure the best cosmetic outcome is to consult with a board-certified plastic surgeon and follow all postoperative instructions.
