Is it time to replace your breast implants?

You might be surprised to learn that breast implants are not a get-it-and-forget-it device. They need to be maintained and even replaced. Whether you already have implants for aesthetic or reconstructive reasons or are considering getting them, they need ongoing monitoring for leaks and typically need to be replaced every 10 to 15 years.

Breast implants consist of a silicone shell filled with either saline (salt water) or silicone gel. Throughout the years, advancements have made these implants more durable and reliable than ever before. However, according to ASPS Member Surgeon Karen Horton, MD, MSc, FACS, FRCSC, they are not immune to wear and tear and will eventually break down over time.

"An implant is a medical device, it's not designed to last forever," said Dr. Horton. "Like any foreign body, they can become infected, they can wear down over time and you might need to have a replacement."

How long do breast implants last?

In the United States, there are three leading companies that manufacture implants for aesthetic and reconstructive breast surgeries, and their warranties vary. Allergan and Mentor offer a 10-year warranty, and Sientra's is 20 years.

The U.S. Food and Drug Administration (FDA) has given no formal timeline for the replacement of breast implants and leaves it up to the consumer to decide when to do so.

According to ASPS Member Surgeon Lara Devgan, MD, breast implants are not considered lifetime devices, and many women choose to replace them at some point.

"There is no formal expiration date on breast implants, so that point could be somewhere in the 10- to 20-year range," said Dr. Devgan. "But it could also be whenever life, aging and circumstance has led to a change in aesthetic outcome."

Bodily changes that may call for breast implant replacement include:

• Pregnancy
• Nursing
• Weight gain or loss
• Aging

Complications that call for replacing implants

Medical issues sometimes require a breast implant to be replaced. These include capsular contracture, a condition where the scar tissue that naturally forms around a breast implant tightens and hardens, causing the breast to feel firm and potentially painful. Infections that causes redness, swelling and fever could require surgical intervention if they can't be resolved with antibiotics.

Breast implants can also potentially rupture or leak. You'll know right away if your saline implant ruptures because the salt water will leak out of the implant and the breast will flatten or appear smaller than usual. This does not cause any damage and is considered an aesthetic issue only.

Should a silicone implant rupture, it's sometimes undetectable because the silicone is so thick that it mostly stays close to the breast implant. However, women might notice a change in the size and shape of their breast or lumps. More frequently, though, women do not know that their silicone implant has ruptured until they undergo MRI or ultrasound imaging.

"If a patient were to find out either by MRI or ultrasound their implant has broken down, I usually would recommend that we would go back to the operating room, remove that broken implant, clean everything up and put in a new one, but it's not a threat to their life or their health," said Dr. Horton. "It's not an emergency."

Guidelines for implant imaging

The FDA recommends that women with breast silicone implants have an initial MRI or ultrasound five years after surgery and every two or three years after that. A breast implant imaging test can be ordered by a general practitioner, gynecologist or plastic surgeon.

"I have an ultrasound in my office, and patients can come in, and I can look for them in my office," said ASPS Member Surgeon Kelly Killeen, MD. "It's only a few-minute exam. It doesn't hurt. It's an easy thing to do."

Also, it's important to note that a regular mammogram doesn't detect silicone breast implant ruptures.

"Even if you get an ultrasound as part of your breast cancer screening, most breast centers will not look or do not specifically look at the implant," said Dr. Killeen. "They're usually looking at your breast tissue, and so unless that's specifically ordered and requested, I've had many patients with ruptures that were clear on ultrasound, and it was not noted on reports because that was not what the study was looking at."

Factoring in upkeep

Despite being more durable and reliable than ever, breast implants aren't meant to last forever. Typically, they need to be replaced every 10 to 15 years, but pregnancy, nursing, weight changes and aging can speed up that timeline. Medical issues like capsular contracture or implant rupture might also mean it's time for a swap.

It's crucial to monitor your implants' condition. The FDA suggests regular check-ups with ultrasound or MRI, as this is better at spotting problems than mammograms. Staying on top of this maintenance helps keep everything in good shape and prevents any health issues down the line. So, if you have or are considering getting breast implants, remember to factor in their upkeep as part of the plan.

Consult with a board-certified plastic surgeon who is an ASPS member to see if breast implants are right for you and to better understand the maintenance involved with getting them.

To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.