Do implants have to be replaced just because they are old?

Have Replicon 22 years. Do they need to be replaced just because they are old?

Doctor Answers (9)

Do implants have to be replaced because they are old?

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Thank you for your question!  There is a common misconception out there that you must replace your implants every 10 years or so.  If your implants are not causing you any problems, then there is really no reason to replace them.  If you are experiencing issues, then it would be a good idea to go see a board certified plastic surgeon for an exam and go from there.  ac


Newport Beach Plastic Surgeon
5.0 out of 5 stars 4 reviews

Should Breast Implants greater than 20 years be replaced

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Perhaps the best answer I can give is that if you were a member of my family, I would recommend that you have them replaced. There is greater than a 50% chance that  your implants that are 22 years old are already ruptured statistically by some of the published literature. A MRI scan would be the best (most sensitive and specific determination). If they are ruptured then removing the lining around the implant (capsulectomy( is recommended to get rid of the traces of silicone. If you are fortunate enough to have unruptured implants that are soft then simple replacement is all that is needed. Although I cannot fault the "wait and see" recommendations that others have given, not having to do a capsulectomy if not ruptured will be less of a procedure and a faster recovery.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 50 reviews

Replacing implants that are otherwise 'fine'

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is not necessary.  Dr. Tholen provided a very thorough answer and specific for your Replicon implant with the polyurethane lining.  And as the others have said, seek revision surgery when you have problems, not just because of the age of your implants.

Curtis Wong, MD
Redding Plastic Surgeon
4.5 out of 5 stars 17 reviews

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When Should Breast Implants be changed?

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Breast Implants are designed to last a long time - however they do not last 50 years, so if you are 22 and having breast implants placed, you should expect to have at least one operation to change them during your life.  The question is - what are the indications to replace them?
1) They are ruptured
2) You have a firm implant - or capsular contracture.
3) Significant asymmetry or malposition of your implant.
Do you need to have them replaced because they are ten years old - no

Richard Greco, MD
Savannah Plastic Surgeon
5.0 out of 5 stars 11 reviews

Implants and replacment

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Implants only have to be replaced if there is a problem with them. There is no specific time frame to replace them.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

Do implants have to be replaced just because they are old?

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there are different schools of thought. If your breasts are soft and without problems I would leave them alone. You will not be making them better as they are fine. If the implants are ruptured, which they may have been for many years, the gel is contained within the scar covering the implant.

Other doctors would be more aggressive and do MRI's and replace the implants if they are not intact. If you are a female wrestler and subject to a lot of trauma this might be a good idea in case the scar tissue ruptures and spreads silicone into the armpit.

I don't think there is a right answer. But I certainly wouldn't replace them just based on age

Val Lambros, MD, FACS
Newport Beach Plastic Surgeon
5.0 out of 5 stars 3 reviews

Do implants have to be replaced just because they are old?

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There is not a specific life span for implants. There is no reason to exchange implants just because they are old. For some reason patients always ask "my implants are 10 years old, do I need to replace them". The answer is no as long as there are no problems with the look, feel and appearance of the breasts and you have had routine followup exam by your surgeon. I like to see all my patients on a yearly basis at no charge. This is to insure that no problems exist with the breast augmentation.

Shahriar Mabourakh, MD, FACS
Sacramento Plastic Surgeon
5.0 out of 5 stars 84 reviews

Should you exchange 22 year old Replicon breast implants?

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Short answer: if you are experiencing no problems such as capsular contracture, malposition, or concern about rupture causing visible or palpable distortion, then yes, of course they (both) should be replaced.

But in the absence of problems, and assuming you still like the look, position, size, and "feel" of your breasts as they are now, then absolutely not!

The polyurethane covering of your Replicon cohesive gel implants was designed to be incorporated into the capsule your body formed around your implants, and capsular contracture was indeed reduced in women who had these implants. Polyurethane-coated implants were often used as "solutions" for difficult capsular contracture patients when nothing else seemed to work. The polyurethane was gradually degraded and incorporated into the scar capsule over many years, and is likely mostly gone or in microscopic remnants after 22 years, but with the beneficial effects of minimizing capsular contracture still present.

I have been performing breast augmentation for 27 years (29 if you include my plastic surgery fellowship), so I used many polyurethane implants before the FDA restrictions of 1991 caused all but two implant companies to leave the marketplace (polyurethane-coated implants were one of the options lost to patients). I still feel that these were excellent implants and have many of my own patients with soft breasts and Replicon implants. Polyurethane-covered implants are still used in Europe and many other countries of the world, but were never re-approved by the FDA here (studies too expensive for the relatively small market share they commanded) in the United States.

The question of what to do if your breasts look great, feel soft, and you are experiencing NO problems or concerns (other than the fact that your implants are 22 years old, and you perhaps expressed concern about that to your doctor, who ordered an MRI scan) is what to do if that darn MRI report says "Ruptured implants." Should a plastic surgeon remove implants in breasts that feel normal, soft, and are having no issues at all in an asymptomatic patient simply because an MRI scan says "Ruptured Implant(s)"? To answer this  properly, one must realize several things:

First of all, radiologist are trained to "decide." They cannot be of value if they simply prepare a report that states "Possible rupture" or "Probable rupture." That would generate a phone call from the ordering physician asking "I already know that, I need to know how possible, probable, or give me a percentage." So, radiologists are trained to decide. Right or wrong, they will "make the call" because that is the only information that would be of value. So, of course, in order to "catch" all of the "really ruptured" implants, they have to "over-call" a bit to ensure that no truly ruptured implants slip by.

The same thing occurs when pathologists look at microscopic cells and must decide "cancer" or "not cancer." They too are trained that it's OK to occasionally be wrong (as long as they err on the side of catching ALL of the real cancers, and overcall a few actual non-cancers as cancer). Of course that means deforming surgeries to remove (not really) cancerous organs, chemotherapy, radiation, and maybe even a few unanticipated complications or deaths, but they HAVE TO MAKE THE DIAGNOSIS! Pathologists often say they may sometimes be wrong, but they cannot ever be in doubt.

Just as radiologists may overcall a few actually-intact implants that simply "look" ruptured on MRI scan.

How often does this happen?

This is certainly a reasonable question, and fortunately, we have information about that. Up to 21% of MRI scan reports that diagnose a "ruptured implant" have been shown to be incorrect (intact implant) at surgical exploration. Wow; that's over a fifth of unnecessary operations, costs, risks, etc.!

So, to summarize: if your breasts feel fine, look fine, and you haven't had an MRI, don't get an MRI and go in peace and enjoy your continued good fortune!

If your breasts feel fine, look fine, and you have that darn MRI that says ruptured, you really have to decide if your surgeon is operating to "fix" a real problem or if s/he's just operating on a report. My bias is that I operate on patients where I can fix a concern; I DO NOT operate on scans when my patient is asymptomatic.

If your breasts are too firm, implants malpositioned, too big, too small, or seem lumpy or possibly ruptured, skip the MRI scan and proceed with surgery; plan on your surgeon removing the capsule and placing new implants. Whether or not your old ones are ruptured is a moot point--your surgeon is fixing a problem and new implants are part of the solution!

Best wishes and Happy Holidays! Dr. Tholen


Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 144 reviews

Replacing implants

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There is no expiration date on breast implants. And they do not need to be replaced just because of their age. But, implants are not meant to be lifetime devices either. Some surgeons would suggest exchanging the implants after a certain amount of time (10-15 years) so that the exchange surgery would have a lower likelihood to be complicated by a rupture. Other surgeons would suggest only exchanging or removing the implants if you start to develop a problem with them. Neither opinion is right or wrong because both have some merit. 

William T. Stoeckel, MD
Raleigh-Durham Plastic Surgeon
5.0 out of 5 stars 44 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.