Breast implants are a medical device used to increase breast size and enhance breast shape. Placed during a surgery known as breast augmentation, the implants and the surgery that places them are the most popular and common plastic surgery in the United States with hundreds of thousands of people undergoing breast augmentation every year.
Getting breast implants is not always a purely cosmetic decision for patients. Many patients get breast implants to reconstruct the breasts or address extreme asymmetry. Out of all plastic surgeries, breast augmentation has one of the highest satisfaction rates. Another common misconception is that breast implants are permanent.
Modern breast implants are designed to be long lasting, but not necessarily permanent. After ten years, the risk of rupture or similar weakening of the breast implant shell goes up. While silicone leaks are largely a thing of the past, patients should still consider replacing their implants at some point after the ten year mark. Though, this is not a requirement. If a patient is not having problems and is still happy, there is not a reason to replace them.
Today’s silicone breast implants—in comparison to older versions—contain a more cohesive silicone gel. This makes them significantly less likely to leak and remain within the shell in the rare event of a rupture.
Different Types of Breast Implants
There are two primary types of breast implants: saline and silicone. Each has unique pros and cons which patients must consider carefully when picking out their breast implants. By far the most popular breast implant option is silicone, but they are not right for everyone. Let’s further examine the pros and cons of saline and silicone breast implants.
Pros of Saline Implants:
● Able to be safely overfilled for maximum breast size
● Filled with sterile saline that poses no risk to the body
● Rupture quickly evident if it occurs
● Require a smaller incision
● Less expensive
Cons of Saline Implants:
● More likely to be visible from under the skin (rippling or wrinkling)
● May hear or feel water sloshing
● Some believe they look and feel less natural than silicone implants
Pros of Silicone Implants:
● Believed to look and feel more natural
● Ability to choose between smooth and textured implants
● Offers shaped implants that mimic the natural shape of the breasts
● Cohesive silicone filling that feels like human fat
● May last longer
● More variety
Cons of Silicone Implants:
● Requires a slightly larger incision to place
● Poses more risk to the body if it ruptures
● Rupture often not immediately detectable
● More expensive
How Long Does Breast Implants Last?
Saline and silicone breast implants have a general lifespan where patients may consider breast implant replacement. In general, saline and silicone breast implants are designed and approved to last more than ten years. Though, after ten years, saline implants have a higher chance of rupturing than silicone breast implants.
If a saline breast implant ruptures, it will deflate which makes the rupture obvious within a day. A silicone implant rupture is harder to detect. It generally requires an MRI to find. Additionally, it is also not an uncommon occurrence for a surgeon to discover ruptured implants during a breast implant removal surgery.
The FDA recommends that patients with breast implants—in particular silicone implants—get MRIs every three years to monitor the integrity of their implants. Patients can also choose to monitor their implants with their doctor.
If a patient discovers that their implant is ruptured, they should contact their plastic surgeon immediately. The ruptured implant will need to be removed. Then, the patient can decide to undergo breast implant replacement or breast implant removal. If only one implant ruptured, patients may only need to correct one breast.
Rupture can occur for various reasons. The most common reason ruptures happen is simply age and wear and tear. Like anything else in the body, the implants may weaken over time. In rarer cases, trauma to the chest, severe capsular contracture, or overfilling/underfilling a saline implant can also cause an implant rupture.
Reasons Why You Need To Replace Or Remove Breast Implants
Breast implants may need to be removed or replaced for various reasons. Of course, a patient can choose to have their breast implants removed at any time for any reason. Sometimes, patients simply outgrow their implants and feel they no longer fit their lifestyle. However, other reasons a patient may seek breast implant replacement or breast implant removal include:
● Rupture: The bursting or an opening in the breast implant. This can cause the filling to leak from the implant. This is rare with modern silicone implants. However, any ruptured implant needs to be removed and/or replaced.
● Capsular Contracture: It is normal for a thin layer of scar tissue to form around the implant. When capsular contracture occurs, the scar tissue becomes thicker and harder. In severe cases, it can cause pain and a misshapen breast. Unless a very mild case, capsular contracture usually warrants breast implant removal.
● Rippling: Rippling—sometimes called wrinkling—is when the implant is visible because it bulges against the skin. While this is not dangerous or worrisome, some patients find it unsightly and choose to place implants under the muscle or pick implants less likely to ripple.
● Shifting: During surgery the plastic surgeon creates a pocket for the breast implant to sit in. Sometimes—for various reasons—the implant may shift out of the pocket or even make the pocket bigger. This can cause the implant to sit incorrectly in the breast. For example, breast implants may sit too far to either side or drop too low.
How Do I Know if My Implants Need to Be Replaced?
Knowing when to seek breast implant replacement is sometimes obvious. For example, if a patient is experiencing pain obviously linked to their implants or a misshapen breast at the wrong stage after surgery, these are likely indications for breast revision surgery. Also, a patient does not necessarily need a reason beyond their own preference. As women grow older and change, they sometimes choose to have their breast implants removed.
Breast implants can have different longevity for each individual patient due to unique factors. Understanding what to expect before choosing to get breast implants allows patients to take steps to extend the longevity of their breast implants and breast augmentation results.