No set rule as when to change breast implants

It is impossible to tell someone exactly how long their implants may last.  It is possible that it could be for a lifetime. However, I tell my patients that they should not have breast implants placed unless they are open to having another surgery some time in their lifespan. Patients do need to understand that breast implants can 'fail', i.e., a saline implant can deflate and a silicone implant can 'rupture'. 

One will readily notice if their saline implant is deflating as their breast will become smaller withing a few hours to few days. Ruptured silicone implants may cause some sort of physical deformity or hardening of the breast; however, many times the rupture is considered 'silent' as their is no visible evidence of a rupture. MRIs are the best way to detect a ruptured silicone implant, however, ultrasounds or mammograms may also detect ruptured silicone implants to a lesser degree.

Patients who see their doctors annually have their implants in an average of 10-15 years. However, that doesn't mean they need to be replaced during that interval; many patients have their implants even longer and are problem-free. However when problems such as the ones described here come up, it is imperative to see your doctor to have an examination.

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There really is not need to replace them if you are not having any issues.  The implants have a lifetime warranty and could perhaps last that long but most often revisional surgery is needed to perhaps perform a lift or go larger or smaller.  At that point most surgeons would replace the implants given the fact that you are in the operating room and under anesthesia.

Most patients at this point desire to change size and some perhaps want to switch to silicone implants from saline.

Hope that answers your question.

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 Regarding your rash - i would definitely see your surgeon as soon as possible.

In regards to when to replace them, I share the same opinion as a lot of the others on this forum - if there is no problem with your breasts and they look fine, there really is nothing to do. Now if you have a change in shape, increased pain, develop hardness or lumps, change in volume, these are reasons to consider doing something or exchanging them.

You need to be examined by a competent and experienced plastic surgeon. Whether or not an implant needs to be replaced is independent of your symptoms. Generally speaking, implants do not have to be replaced unless they are not functioning in the way that they were intended. If we are talking only about leakage, saline implants will demonstrate leakage by a decrease in size or shape. Silicone implants may not change the breast size, shape or consistency, thus the "silent" leak.

Rash and discoloration may indicate leakage of silicone implants or thinning of the overlying soft tissue with either saline or silicone implants but without leakage. Both may indicate a need for re-operation. It is the fact the we know that implants may not last a lifetime and can leak that requires your situation be given serious examination. 

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Implants can be replaced for elective reasons such as a desire to change from saline to silicone or a request for a larger size. The medical indications for removing implants are rupture of the implant or capsular contracture.

Years ago many surgeons told patients to change their implants every ten years because the predominant implants at the time were siicone and there were no reliabel studies to determine implant rupture.

Today we have reliable studies with MRI and we have better quality implants. As long as the implants are intact and you are pleased with them you do not need to replace them.

Your comments about a painful rash and "feeling air pockets" is concerning to me. On rare occasion the pressure of the implants on the breast skin can lead to skin loss and exposure of the implant. This requires immediate medical attention.

There is also a type ofbreast cancer which presents as a rash involving the breast skin. It is called inflammatory breast cancer and this also requires immmediate attention.

I am not trying to scare you as this may simply be a rash but I encourage you to see your plastic surgeon as soon as possible

I wish you all the best.

The decision of replacing implants depends on your type of breast implants (saline vs. silicone). Your breast implants can be replaced when the implants fail. This can be 5 years, 10 years or even 30 years.

The detection of a fail saline implant is very simple. The breast with the failed breast implant will deflate. When this happens, the breast implant will need to be replaced.  The same applies to silicone implants.  owever, the failure of silicone implants is harder to detect, since the breasts do not immediately deflate. For this reason, some patients will prefer to have their silicone breast implants switched out before silicone implant fails for fear of exposure to the silicone gel.  

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Both major US breast implant manufactures have a lifetime warranty on their implant, as well as a 10 year warranty on the replacement cost, if they deflate.

Therefore, your implants are good forever, but statistically, according to the FDA, most women tend to change their implants (not beacuse of the implants) within 18-20 years.

Hello, When you ask this question, the answer really depends upon the type of implant you have had placed. A rash under the breast is especially worrisome. When the implants are silicone gel implants, it might mean that the implant has ruptured and the gel is affecting the tissues including the skin.

Your mention of "air pockets" makes me think you likely have saline implants. The rash indicates a reaction, so I would get this evaluated by your plastic surgeon ASAP.

When saline filled implants rupture, the process is more noticeable as the breast loses size rapidly. The body absorbs the saline and there is usually less of a worry from a "reaction" standpoint. Saline implants when they last (they may rupture more readily) can last 10-15 years.

Newer generation silicone gel implants (Cohesive Gel) may last longer. We don’t have much data on the longevity of Cohesive gel implants as they are newer. I have posted a Youtube video showing some silicone gel scar capsules I removed for a woman with really old silicone gel implants for your information.

Best Regards,

John Di Saia MD

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