I've heard so many different opinions...I'm planning on a breast augmentation with silicone implants. I know that implants are not necessarily "lifetime devices", but how often do I actually need to plan on having revision surgery? Is it possible not to?
I've Heard So Many Different Opinions About Implant Revisions
Doctor Answers (11)
Need for Breast Implant Revision Less Likely With Proper Surgical Technique
Thank you for your question.
Although Government statistics report a 20% revision rate for Breast Augmentation, studies show that when proper patient selection and proper surgical technique is used that rate decreases to 6%.
The most important thing for you is to choose your surgeon wisely. Find a surgeon who is certified by the American Board of Plastic Surgery who is experienced in Aesthetic Breast Surgery. Read his reviews and try to speak to former patients.
Newer Breast Implants (post 2000) have a much thicker outer shell and are less prone to rupture than older (pre 1970) implants.
Although the FDA classifies Breast Implants as not lifetime devices, many patients have implants that are fine after 30-40 years. Current expectations are that you may need a replacement or revision after 10-15 years but it does vary with the individual. These statistics also include patients who do not have a problem with their implants but simply want to have larger implants.
Breast augmentation: long term issues.
Implants could last forever but they are generally not intended to do so, Regular follow up with your plastic surgeon will determine the best course. I you are looking for a "permanent" solution, you may want to start looking into the option of fat grafitng.
How likely is a breast augmentation revision?
It is best to assume that at some point in your life you will need a revision. This is usually due to a deflation, or rupture or capsular contracture. I would recommend buying the "enhanced warranty" which is good for 10 years and will cover a good portion of your "redo" surgery. There are some lucky women that have their implants for life.
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Breast Implant Revision Rates
There are many studies looking at breast implant revision rates. In these studies, revisions range from 2% to 30%. When looked at carefully, the reasons for revision fall into one of two groups. The first is technical and the second is communication. Both silicone and saline implants are great devices. However, if the surgeon takes shortcuts when inserting them, the wall can be weakened, bacteria can become attached or other things can happen to the implant, leading to a revision. If you do not communicate your desires precisely to your surgeon, or he/she does not understand you, you may decide to change for another size, etc. Therefore, it is imperative that you find (by asking) a surgeon with a revision rate less than 3%. This assures that both technique and communication is excellent.
Breast implant revisions
There is no set time to determine when you need a replacement. But the literature supports the concept that the implants are not a life time product and sometime "down the road" you will more than likely need an additional operation.
So Many Different Opinions
As you state the implants are life time. Replacement is only if you have a deflation, capsular fibrosis. Do not plan on a revision just to do it. From MIAMI Dr. Darryl J. Blinski, 305 598 0091
You may never need revision of breast implants.
The latest study showed an incidence of leaking implants of only 2% at 6 years. So they may last you a lifetime.
Need For Revision after Augmentation Varies
There is no hard and fast rule for when or even if revisional surgery may be required following augmentions. I have a retired partner who has patients who have had implants for 35-40 years and have never had a secondary surgery. I have also had patients who developed deflation of a saline implant within weeks of their surgery.
Silicone Gel Implants
Nobody can answer that question for you. They could last you forever without problems or they may rupture at some point so you would need a revision. I tell most of my patients that you should expect to have at least one more surgery in your lifetime due to the fact that you have breast implants.
You should get an MRI 3 years after your surgery to see if there is any rupture.
Sorting through contradictory advice on implant revision surgery
It is true that the FDA requires product labeling for breast implants to disclose that they are not expected to be lifetime devices, and that replacement every 10 years is the norm. However, the manufacturers that sell implants in the U.S. both have lifetime replacement policies, meaning a new implant free if they ever fail. Obviously they are not planning to give out new implants every 10 years, meaning they do expect most of them to last a lifetime. The 10-year number comes from historical averages with outdated implant designs, and in my experience implant "rupture" is rare. (That is really the wrong word, since if the outer shell develops an opening, a saline implant will harmlessly deflate, and nothing much happens with a silicone implant since the gel filling is a cohesive semisolid and doesn't "leak.") Revision surgery is most likely to be done for size change, capsular contracture, or other issues.