Choosing to undergo breast augmentation surgery is only the start of a big, exciting journey; after you make that initial decision, you’ll find you have many more things to consider. First up is likely: “How do I find the best surgeon for me?” Then you have to think about details like the location of the incision, whether you’re opting for under- or over-the-muscle implant placement, the level of projection you’d like from your implants, and your ideal future cup size—not to mention the breast implant brand itself. Not all implants are the same, and it’s important to research the safety data around the ones you’re interested in.
Many breast augmentation patients love getting into the nitty-gritty of the procedure and its related details—and why not? It’s an opportunity to achieve the results of your dreams. But aside from saving breast inspo pictures on Instagram, bookmarking future lingerie purchases, and getting your post-op recovery kit together, there’s one other detail that’s worth focusing on: the breast implant manufacturer’s warranty.
While it’s pretty unlikely you’ll need it (especially if you book your procedure with an experienced and board-certified plastic surgeon), a solid, comprehensive warranty can help provide peace of mind so you can go into your surgery with even more confidence. Warranties differ greatly among implant brands, from the type and length of the coverage to the amount of financial support provided. Here, we break down the world of breast implant warranties into simpler terms.
What exactly is a breast implant warranty?
Breast implants are not lifetime devices, and you should go into your first breast augmentation procedure prepared for the possibility that you may have to replace them someday. The good news is, if there’s an issue with your implant that requires surgical intervention, your breast implant manufacturer’s warranty may help.
“The warranty is like insurance—it’s there to offer financial assistance if you have a problem,” explains Dr. Melinda Haws, a board-certified plastic surgeon in Nashville and Sientra Advisory Board member. And just like with insurance plans, breast implant warranty coverage varies from brand to brand. Currently, there are four FDA-approved breast implant manufacturers, and while each offers a warranty program, the options are not the same.
Remember, a warranty is designed to offer financial assistance or to replace a product in the case of a serious issue, which is largely uncommon. “In my practice, it is not very common for the warranty to be used,” notes Dr. Adam Schaffner, a board-certified plastic surgeon in New York City. “In the past 10 years, I have treated approximately one patient per year who has used the warranty.” What a warranty isn’t: a free pass in the case of buyer’s remorse. If you are unsatisfied with your breast augmentation results or wish you’d picked a different size—but there is no problem with the implant itself—you’re not covered under a breast implant warranty. That’s a conversation to have with your plastic surgeon.
What do all breast implant warranties cover?
Currently, all four FDA-approved breast implant manufacturers offer a lifetime guarantee in the case of a rupture. “When implants fail inside the body, it is usually a “wear and tear” [issue] from a fold in the implant or a tear along a seam,” explains Dr. Haws. if one of your implants were to rupture due to a wear and tear issue, at any point after your procedure, the company behind the implant would cover the cost of a replacement. In fact, all four manufacturers offer contralateral implant replacement as well—so when surgically replacing your damaged implant, the company will give you a second implant, to replace the unaffected one in your other breast.
While your implants are covered indefinitely for replacement if they rupture, it’s important to note that financial help for the surgery itself doesn’t come with a lifelong guarantee. Most brands will provide you with several thousand dollars in assistance for up to 10 years after your surgery; Sientra is the only breast implant brand that extends that window of time to 20 years and covers some of the most common complications that can occur with breast augmentation, such as advanced forms of capsular contracture, double capsule, late-forming seroma, and BIA-ALCL (we’ll get to all of those in a bit), at no additional charge to the patient. “Sientra not only has an exceptional implant, with numerous options for gel cohesivity, implant fill, and implant profiles, [it] also [has] the most comprehensive warranty program of any of the U.S. breast implant companies,” adds Dr. Haws.
How do I know if I have an issue that is covered by a breast implant warranty?
There are specific problems that are covered by most breast implant brands’ warranties, but the majority of them can be invisible, including ruptures. This is why follow-up appointments with your provider are so important—they are highly trained to notice even the smallest concern. But you have work to do too: According to Dr. Ashley Gordon, a board-certified plastic surgeon in Austin, Texas and Sientra Advisory Board member, performing a monthly self-examination and booking annual mammograms after the age of 40 can go a long way toward tracking the health of your implants.
If you’re not feeling or seeing any change to your implants, you should still have your surgeon evaluate your breasts annually, with more significant analysis a few years post-op. “The FDA just released guidelines that silicone breast implants should be evaluated for rupture by high-resolution ultrasound or MRI after five or six years, then evaluated every two to three years after that,” shares Dr. Haws. “Many plastic surgeons are incorporating high-resolution ultrasound in their practices and can evaluate their patients’ implants in the office.” Be sure to ask your surgeon, during your consultation, about their protocol for breast implant evaluation.
This might sound obvious, but if you’re noticing discomfort or any other differences in your breasts, go see a doctor. “If a woman has pain, redness, change in size, shape, or feel of the breast, she should promptly schedule an appointment to see a board certified plastic surgeon, to be examined,” warns Dr. Schaffner. Hopefully, there’s no serious problem at play, but if there is, catching it early will help. And remember, your implant evaluation would be “in addition to imaging performed for breast cancer screening,” he points out.
Aside from ruptures, do breast implant warranties cover other complications?
There’s a handful of issues that can occur due to breast augmentation surgery; some tend to form during the healing process, while others appear later. The most common concern is capsular contracture, which is caused when the body recognizes the implant as a foreign object and creates an overly hard “capsule” of scar tissue around the implant. It’s normal for your body to create this capsule, but it typically stays soft.
Capsular contracture is graded with the Baker scale, which ranges from I (no capsular contracture) to IV (severe capsular contracture). In cases with a III or IV grade on the Baker scale, the capsule can push the implant far up the chest and clench it in a way that looks highly unnatural. These instances will likely require revision breast augmentation surgery and possibly a capsulectomy—the removal of the hardened capsule in its entirety—to help restore the breast to its previous appearance.
While all four FDA-approved breast implant brands will replace your implants if you have a case of capsular contracture that rates a III or IV on the Baker scale, most brands will do so only within 10 years of your initial breast augmentation. Sientra will replace them within 20 years as well as provide financial assistance of up to $2,000 within the first two years. Notably, Sientra’s Platinum20 warranty also covers the implants in any revision or reconstructive augmentations. Most brands won’t cover reconstructive or revision procedures if you have a prior history of capsular contracture—which, if you’ve had capsular contracture, is extremely frustrating and can be financially overwhelming, considering you’ll require the surgical help to re-create a “normal” looking breast. With Sientra’s Platinum20 warranty, you would be covered even if you’ve had a prior history of capsular contracture.
A similar concern is double capsule, which is like the Inception of capsular contracture: a hardened capsule forms within another. This rare issue is covered, to a certain degree, by most—though not all—implant makers. Sientra offers the same warranty for double capsule as it does for capsular contracture; 20 years of coverage, with two years to secure financial help of up to $2,000.
The two final and more serious issues that are covered by most breast implant warranties are BIA-ALCL (breast implant–-associated anaplastic large-cell lymphoma, a form of non-Hodgkin’s lymphoma) and late-forming seromas. “BIA-ALCL presents, more than 85% of the time, with a seroma,” explains Dr. Haws. “A seroma is fluid accumulating around the implant, so [it] presents as one side bigger than the other.” Remember how your body creates a capsule around your implants? The fluid in a seroma is contained in that capsule—and typically, in cases of BIA-ALCL, the cancerous BIA-ALCL cells are cells located in the seroma within the capsule. Thankfully, that means that this form of cancer is frequently successfully treated by removing the breast implant and surrounding scar tissue.
Because these two conditions are particularly serious, it makes sense that most breast implant brands take care of implant replacement, revision, and reconstruction in these cases. However, Sientra is the only breast implant manufacturer that provides testing of late-forming seromas for BIA-ALCL, implant replacement, and up to $7,500 of financial assistance for up to 20 years. During your consultation, your doctor should thoroughly explain all risks and help you come to a confident decision as to the implant manufacturer and type that are right for you.
Are there any circumstances that would void a breast implant warranty?
While the best way to understand the finer points of a manufacturer’s warranty is to read it in full (considering they’re all different), there are some conditions that could nullify it. For example, the FDA has approved the use of silicone breast implants in adults over the age of 22. As a result, if you’re under 22 and choose silicone implants, it is possible you won’t be covered by a warranty.
The type of damage sustained to your implants also matters. Dr. Haws explains that if a rupture occurs due to deterioration of the implant caused by a surgeon’s error during surgery, your warranty will be voided. “The implant companies like to evaluate the implant shell after [removal], to determine what caused the rupture,” she says. Your chances of surgical errors can be significantly reduced when working with a board-certified plastic surgeon, which is why it’s so important to thoroughly review doctors’ credentials as part of your breast augmentation research. Sientra is the only implant manufacturer that sells exclusively to board-certified plastic surgeons.
If I replace my breast implants under a warranty, can I make some changes to my initial choices?
To a certain degree, you can revise your original “order,” though it’s important to check each warranty. Switching brands under a warranty is a hard no—you must be exchanging your damaged implants for new implants from the same company. You also need to stay in the same product category: “You can’t switch from a saline implant to a gel,” explains Dr. Gordon. “Saline to saline is covered, and gel to gel is covered.”
Otherwise, “in most cases, a woman may select a different-size implant, if desired, when the implant exchange is covered by the manufacturer’s warranty,” says Dr. Schaffner. This includes changing your implant size and projection (regardless of whether you’re going bigger or smaller), the incision placement, and whether you opt to go over or under the muscle. “Should the patient select a different, more expensive type of implant distributed by the same manufacturer as the implants covered by the warranty, the patient would be required to pay the difference,” adds Dr. Schaffner. (While this seems to be a pretty standard policy, all warranties are unique. In a circumstance like this, you’ll want to inspect yours closely, to determine whether your reason for replacement and the brand you use will require you to pay a little more for an “upgrade.”) You can also opt to book your replacement surgery with a different surgeon from your initial provider, if you’d prefer.
Breast augmentation has a 97% Worth It Rating on RealSelf, making it one of the most popular plastic surgery procedures, and currently, Sientra is the highest-rated breast implant brand in the U.S. on RealSelf. Finding the right board-certified plastic surgeon, who will explain all your breast implant options and help you choose the right one for your goals, is the best way to decrease the chances you’ll experience complications and ensure that you feel confident in your decision.
Important Safety Information
Sientra’s Silicone Gel Breast Implants are indicated for breast augmentation in women at least 22 years old and for breast reconstruction. Breast augmentation includes primary breast augmentation to increase the breast size, as well as revision surgery to correct or improve the result of primary breast augmentation surgery. Breast reconstruction includes primary reconstruction to replace breast tissue that has been removed due to cancer or trauma or that has failed to develop properly due to a severe breast abnormality. Breast reconstruction also includes revision surgery to correct or improve the results of a primary breast reconstruction surgery. Breast implant surgery is contraindicated in women with active infection anywhere in their bodies, with existing cancer or pre-cancer of their breast who have not received adequate treatment for those conditions and, who are pregnant or nursing.
Key complications include capsular contracture, implant removal, rupture and reoperation. For more detailed information about the risks and benefits of Sientra breast implants, please visit sientra.com/resources or call Sientra at 888.708.0808. Sientra breast implants with High-Strength Cohesive silicone gel are only available through board-certified or board-eligible plastic surgeons.
The sale and distribution of this device is restricted to users and/or user facilities that provide information to patients about the risks and benefits of this device in the form and manner specified in the approved labeling provided by Sientra, Inc.
Sientra® and Platinum20™ are trademarks of Sientra, Inc.
