I just got an email from a patient who I did a breast augmentation on 15 years ago. She has regular mammograms, and everything is fine. She is wondering, “Do I need to consider having them replaced at a certain point if I’m experiencing no issues?”
Great question.
All breast implants have a lifespan and need to be replaced. If a saline implant leaks, you know. The salt water in the implant leaks out of the implant and is absorbed by your body. When this happens, the size of your breast will shrink, you may get sensory changes (tingling or itching in the skin as the skin unstretches), and you will see it. Don’t worry. It is not a 911 emergency. I had a patient once who deflated when she was pregnant and we couldn’t fix it for over a year. Other than having to stuff your bra on one side, there is not an issue.
But what about silicone gel breast implants?
There is a warranty on the silicone implants that lasts for 10 years. Like all warranties, I think it is unusual for issues to happen before then. I have been in practice now for 25 years, and I am starting to see my silicone breast augmentation patients trickle back in with leaking implants. Many of them had no external symptoms- they felt fine, the implants were soft and mobile, there was no shape change. They found the implant was suspected of leaking when they did a mammogram.
So what should you do? What do you need to know?
- I have come around to the idea of replacing silicone gel implants 12-15 years after implantation. The implant styles placed about 15 years ago were the Style 10, Style 15, or Style 20 by Allergan. There is now a newer generation of implants (SRL, SRLP, SRM, SRF, SRX).
- If you do not want to replace your implants unless you need to, you should check to see if you have a silent rupture or leak. This can by done by MRI or ultrasound (and many are seen on mammogram).
- The benefit of exchanging your implant a little earlier is the surgery is a simple implant exchange. If your implant is leaking, your surgery is more extensive- a capsulectomy with implant exchange. A capsulectomy is removal of the scar tissue your body formed around the implant with the implant inside. This is a slightly more extensive surgery than a simple implant exchange.
- If your silicone implant has leaked, breathe. It is okay. Your body formed a scar capsule around the implant when it was placed years ago. Silicone gel is not flying around your body- it is caught by that capsule, and extracapsular spread is not common. You want to fix the issue in a timely fashion, but this is not a rush to the operating room issue.
- Use this as a time to evaluate. Do you want to put in new implants? Same size? Saline or gel? Do you need a lift? I see many patients who as they aged have changed what they want. They now want smaller, lifted breasts, and so implant removal with a breast lift is a common surgery I do, particularly for women in their 50s and 60s. For some women they have gained weight with age, so their breasts are larger than they wanted. Again, use this as an opportunity to evaluate what you want.
As always, feel free to come in and talk with me about it. See my pages on BREAST REVISION and BREAST IMPLANT REMOVAL.
So do you have to do a surgery if there are no issues right now?
No. But as time goes on, the risk of a silent leak does increase. Breast implants are not “lifetime” implants. You need to evaluate your tolerance for risk. If you do decide to wait, get a MRI or ultrasound to look for a silent leak. Do yearly mammograms.