The internet is a wonderful source of information, and if you’re considering breast augmentation surgery, it’s very likely you’ve read that you need to change your breast implants every 10 years. Well, it’s a bit more complicated than that.
First, something all women should know is that if you have a breast augmentation, it’s likely that you’ll need additional surgery in the future, as breast implants are not lifetime devices. Some reasons that women may need more surgery include:
- leaking of the implant (also known as implant rupture)
- capsular contracture (overgrowth of internal scar tissue- capsule- around in the implant that can make it feel too firm or look too perky)
- malposition (the implant has shifted to a position that’s too low, too high, or too far to the side)
- size change (this is usually a personal preference)
When it comes to capsular contracture, malposition, or size change, these all fit into the category of “if it bothers you, fix it.” None of these NEED surgery, but surgery is required if you want to make them look or feel better. A leaking implant is another matter, but lets first talk about different types of implants.
There are 2 basic types of implants, saline and silicone. They’re both made of the same outer material, the difference is what’s on the inside. A saline implant is filled with salt water (saline) and a silicone implant is filled with silicone gel. That makes a big difference when we think about what happens when they leak. If a saline implant gets a hole in it and leaks, the water leaks out of the implant and is absorbed by the body. It’s not harmful, dangerous, or hard to figure out. One day your breast is full, the next day your breast is deflated. This is usually very obvious to the patient. A silicone implant, on the other hand, leaks its silicone into the space around the implant (the capsule) and it’s not absorbed by the body, so most women aren’t going to notice that anything’s different with their breast, which makes it very difficult to tell if the implant has leaked. This is why the FDA recommends MRI or ultrasound to check for a leak of a silicone implant starting 6 years after surgery (that’s a long topic for another blog).
Whether it’s a saline or silicone implant that’s leaked, it takes surgery to replace it. Replacing a saline implant is usually relatively simple. The old implant is removed and a new implant is placed in the same space. Replacing an intact silicone implant is a similar procedure. Removing and replacing a leaking silicone implant is a bigger operation during which usually the capsule around the implant is removed with the implant to try to get as much of the silicone out as possible. This can also create challenges when placing a new implant in that space and increase the risk of the new implant having malposition as it heals. The bottom line is that it’s much easier to remove and replace a silicone implant if it hasn’t leaked than if it has leaked.
So, getting back to changing the implants every 10 years. The older an implant is, the more likely it is to leak. If you have a silicone implant, there is some benefit to being proactive about changing your implants when they’re relatively young and less likely to be broken.
My general recommendation to patients is, if you have saline implants, put them in and forget about them. If they look good and feel good, they are good. Leave them alone until they tell you there’s a problem, but be prepared with some money set aside to cover the surgery to replace them if you wake up tomorrow with a flat chest on one side. If you have silicone implants, particularly if there’s something you’d like to change about your breasts (for example, size or perkiness), consider having them swapped out when they’re about 10 years old.