This is a controversial topic in which one highly quoted article suggests that breast implants should be replaced every ten years. However, this is not the case according to breast augmentation expert, Dr. David Berman. Breast implants generally do not need to be replaced unless you fit into one of the following situations.
There are 5 reasons to change out a breast implant:
1. It leaks. This will be obvious with a saline implant since they are filled with saline (salt water). They will usually, but not always, empty very quickly. It is not dangerous since they are filled with saline which makes up a large quantity of our body composition. In rare circumstances, Dr. Berman has seen a saline implant develop a slow leak by folding over the leak, this is the only way to develop a slow leak with a saline implant and it is quite uncommon. This can be recognized by viewing a series of pictures over time. It will usually be clear that the implant is getting smaller visually and it will feel like a more empty bag of water, since that is exactly what is happening. In addition, this should be easy to recognize with an MRI since there will be an obvious difference in fill volumes between the two breast implants.
All the silicone implants are now (in contrast with how they were manufactured before 1992 when they were taken off of the American and Canadian market) “cohesive gel implants” making it similar to the consistency of gummy bear candies. If you cut them in half, little to nothing leaks out. A small tear in the shell of the implant is highly unlikely to cause any harm which is substantiated by Dr. Berman’s extensive experience. Pushing for the removal of an implant because of a possible tear seen on MRI, is suggested as a precautionary measure rather than due to proof of health ramifications. A plastic surgeon does not want to knowingly leave a breast implant that “may” have a small defect in the shell, for fear that if any health problem arises it could lead to a potential lawsuit, even if a health issue is unrelated. Dr. Berman, at this time, does not recommend doing an MRI for no clinical reasons, other than to look for a leaking implant. The FDA also recommends that women do regular interval MRI for this purpose. MRI’s are not always accurate in showing a leak for silicone implants. A few years ago, one of Dr. Berman’s patient’s presented an MRI report which “demonstrated bilateral leaking silicone implants.” As per her request, he scheduled surgery to remove the leaking implants and replace them with new implants (The time gap was about 8 years). At surgery, both implants were found to be perfect (thus the MRI was in error). Dr. Berman still replaced them as planned. Fortunately, her recovery was uneventful. However, there are always risks associated with surgery, so it is important to be prudent when choosing to undergo a procedure.
2. It may make sense to change out the implants, if significant capsule formation occurs. Capsule formation refers to scar tissue that forms around the implants. Everyone heals the area around a foreign body, such as an implant, a sliver, or a joint replacement with scar tissue. This is normal. However, in some cases, the scar tissue around the breast implant can get thick and hard and occasionally painful. It is not dangerous but can be uncomfortable or aesthetically displeasing. The solution for this is to remove the implants and usually some or all of the scar tissue/capsule and to place new implants either in a new pocket or the existing pocket.
3. If the woman wants to change breast implant size or no longer wants implants at all. It occasionally happens that a woman wants to increase or decrease the size of her implants. Of course, this requires a change of implants. Occasionally, a woman may decide that she no longer wants implants at all. When this occurs, sometimes a very nice shape will still result. In other cases, there will be laxity of the skin and breast tissue and a breast lift may be needed to achieve the desired breast shape. This can be done at the time of implant removal or one may want to wait 6 months, to see how the breast tissue tightens up over time.
4. If a significant number of years have passed since implants were placed and a major lift is required to help with breast sagginess/ptosis. It may make sense, if general anesthesia is required for the lift to also change out the implants.
5. Very uncommon situations such as lymphoma in the breast capsule etc.
Dr. Berman feels that at this point in time, there is no medical reason to change out the breast implants every ten years have passed. Dr. Berman has plenty of patients who are doing well with their implants 15 and even 20 years after their breast augmentation.