From the “silent rupture” of silicone implants to the obvious deflation of saline, this guide details everything you need to know about implant longevity and when to schedule a replacement.
All breast implants are medical devices that will eventually wear out. Knowing when it’s time to replace them is crucial for your health and the longevity of your results. The timeline for replacement largely depends on the type of implant you have.
Saline Implants: A Noticeable Deflation
Saline implants are filled with a sterile saltwater solution. The moment a rupture occurs, the solution is harmlessly and safely reabsorbed by your body. The implant will immediately deflate, much like a flat tire.
No Routine Screening Needed: Because a rupture is so obvious and immediate, you do not need to schedule routine screenings for saline implants. You will know right away if something is wrong.
Proactive Replacement: While saline implants can last for many years, you might consider a preemptive replacement after 15 to 20 years to avoid being caught by surprise. The reality is that they often “seem to deflate right before people’s children get married!”
Silicone Implants: The Silent Rupture
Silicone implants are filled with a cohesive, gel-like substance. When a silicone implant ruptures, the gel tends to stay within the scar tissue capsule that your body has formed around it. This is known as a “silent rupture” because there may be no visible signs of a problem.
For this reason, regular screenings are essential for patients with silicone implants.
Screening Recommendations: The FDA recommends screening for a silicone implant rupture with an ultrasound or MRI. Your first screening should be done five years after the implant is placed, followed by a screening every two to three years thereafter.
The Importance of an Expert: It’s important to note that an ultrasound can only confirm if a rupture has occurred at the time of the scan; it cannot predict a future rupture. A plastic surgeon with expertise in implant care can perform a thorough assessment during your regular check-ups.
Two Strategies for Replacement
Once you’re aware that your implants will need to be replaced at some point, you can choose a strategy that best fits your lifestyle and preferences.
Strategy 1: Proactive Replacement
The Approach: You choose to replace your implants preemptively, typically after 15 or 20 years, while they are still intact.
Pros: The procedure is usually simpler, quicker, and less invasive because the implant has not yet ruptured.
Cons: This strategy may lead to more surgeries over your lifetime than would otherwise be necessary, as you are not waiting for a problem to occur.
Strategy 2: Waiting for a Rupture
The Approach: You wait until a rupture is confirmed through a screening or becomes clinically apparent before replacing your implants.
Pros: This minimizes the total number of surgeries you might need throughout your lifetime.
Cons: A ruptured implant may require a more involved procedure, such as a capsulectomy, which is the surgical removal of the surrounding scar tissue. This can make the procedure more complex and lengthen the recovery time.
The choice between these two strategies is a personal one. The most important thing is to stay vigilant about your breast and implant health and to consult with a board-certified plastic surgeon to create a personalized plan.
As a plastic surgeon in Denver, CO, if you have your implants placed by me, I offer complimentary follow-up ultrasound screening to all of my patients. However, the ultrasound only gives information on whether the implant is ruptured at that time; it doesn’t tell you if they are about to rupture next week.
