I am asked this question frequently. If the implant is intact and there are no other circumstances requiring breast surgery, there is absolutely no reason to replace the implants no matter how long they have been in place. If, however, the implant has been discovered to have developed a leak, then it is recommended the implant be replaced regardless of how long the implant has been in place. If a saline implant shell develops a leak, it will be immediately apparent within a day or two when the breast becomes significantly smaller. When silicone gel-filled implants develop a leak, it is usually not apparent to the patient or her physician. The gel that may leak out of an implant shell that has developed a tear will, typically, remain within the scar tissue pocket that naturally forms around the breast implant. This gel is not able to be absorbed by the body as in saline filled implants. Therefore, in most instances there will be no change in appearance nor any symptoms associated with a silicone gel-filled implant shell developing a leak. This is why we recommend periodic MRI surveillance be performed to evaluate silicone gel implants that have been in for a certain period of time. An MRI can determine if the implant is intact or not. Certainly if the implant appears to have developed a tear in the shell, we do recommend the implant be replaced. Please be assured, however, that there is no scientific evidence that a silicone gel implant leak leads to any significant medical illness. Nonetheless, because it is a medical device that is no longer functioning as designed, we do recommend replacement.
If capsular contracture has occurred, the patient will notice a tightening of the breast with firmness developing, perhaps a change in the shape of the breast, and sometimes there may be discomfort associated with the tightness of the scar around the breast implant. At times the breast will take on an appearance that looks somewhat smaller and sometimes rises up on the chest a little bit as well. To correct this problem, surgical release and relaxation of the scar tissue pocket is recommended and, at that time, the implant is typically replaced.
If other surgery is being performed on the breasts of a patient who has undergone breast augmentation many years previously, I typically recommend that implant replacement be performed. In my opinion, if the implant has been present for more than eight years or so, there is an increasing likelihood, over time, that an implant will develop a leak in the future. It seems wise to replace the implants when already in the operating room, thus avoiding the inconvenience of future implant replacement surgery. Certainly recommendations will be tailored to every individual’s unique requirements and medical plan.
So please don’t be concerned that if you have had breast implants for ten years that you will need to have them replaced. If everything is fine and you need no other surgery, there is absolutely no reason to replace the implants electively. You can feel completely at ease enjoying the results of your breast augmentation without having to undergo unnecessary surgery.