I have had breast implants for 14 years. How Long Do Breast Implants Last?
Doctor Answers 248
Breast Augmentation: Can Breast Implants Last a Lifetime?
Several large studies have shown saline implant deflation rates of around 1% at 1 year and 3% at 3 years. If this rate of saline implant failure holds true over time, one can expect that 1 out of 10 (10%) patients can expect a deflation in the first 10 years following augmentation. My own experience with saline implant deflation has been less than that: in 6 years of practice in North Carolina I have had only one patient (out of more than 300 patients with 600 saline breast implants) return with a deflation. It is certainly possible that some patients who moved out of the area experienced deflation and did not return to this practice for implant replacement, however we have asked the implant manufacturer to notify us in the event that this happens and thus far we have received no report of additional saline implant failures.
Silicone gel implant failure is a somewhat different issue, as implant rupture can not be detected by looking at or feeling the augmented breast. The gel material is inert and is not absorbed by the body, so the appearance and feel of the implant does not change following rupture of the outer shell. In order to detect a gel implant rupture, a radiologic study, such as an MRI, is required. For that reason, the FDA has recommended that women receiving the recently approved cohesive gel implants obtain breast implant MRI scans at intervals following augmentation.
One study including over 500 patients has shown a gel implant rupture rate of 0.5% at 3 years among those patients who had had a postoperative MRI scan, so the failure rate for the new cohesive gel implants appears to be no greater than what we have seen with saline implants, and may in fact be somewhat lower.
It is worth noting that the material which is used to manufacture the outer shell of saline and silicone gel breast implants is the same, so varying failure rates between the two types of implants probably has to do with differences in the way that the substance that fills them affects the outer shell. I think that it is also important to stress that if a woman's breast implants have not deflated (saline) or ruptured (silicone gel), there is no need to remove and replace either kind of implant merely because a certain amount of time has passed since the augmentation surgery.
How long do breast implant last?
Most breast implants will last a lifetime.
There is a common misconception that implants will only last 10 years. This is not true. If you have no problem with your implant then nothing needs to be done with them. The only reason you would change an implant is if there is a problem with them. The most common long term problem is implant rupture. The risk of a rupture is 1% a year. So the risk of having a broken implant at the end of 10 years is 10%. That means that 90 % of implants will be fine at 10 years. The other common misconception is that saline implants are more likely to rupture than gel. This is not true. The rupture rate is the same for saline and cohesive gel implants because the outer shell of both type of implants are virtually the same .
So most women will live their whole lives with their original implants and will never require additional surgery.
Breast implant exchange myth
Some of the potential complications that may arise would be deflation, capsular contracture, bottoming out, or just size change. If you are happy with the size of your breast implants and are having no problems, you don't need to do anything.
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There is No Expiration Date!
Breast implants are not like cartons of milk, there is no expiration date. Implants do fail in time, as they are man made devices and all eventaully will.
Saline and gel devices have individual rates of failure and to make it easy average around 1% per year. This means in 20 years there is a 20% , or 1 in 5 chance of failure. At 50 years, there is a 50% chance. So just determine the odds. There is no date to change the implants, if they fail, change them.
For saline devices it is easy to know when they fail, they will deflate. Gel devices are not as easy to detect and an MRI is the best way to determine this. Patients can consider getting an MRI 7 to 10 years after augmentation to see if there is implant failure.
If you are pleased with you result, do not worry about changing implants unless there is device failure!
How Long Breast Implants Last.
Many Plastic Surgeons recommend replacement of Silicone Gel Implants after 10-15 years.
However, most agree today that if your Breast Implants are intact and you do not have problems such as Capsular Contracture or Implant Rupture, there is no need to remove Breast Implants that are intact and that you are happy with.
The problem is that rupture of Silicone Gel Breast Implants is hard to detect. That is why the FDA recommends an MRI to check Breast Implant Integrity every 2-3 years.
My personal view is that if your Breast Implants are soft, normal looking and there is no MRI indication of rupture, I recommend not removing them.
However, your rash may be caused by the pressure of the breast overhanging the upper abdominal skin and this may be a reason to remove them or have a Breast Lift to elevate the overhanging tissue. See your Plastic Surgeon for an exam and advice. Do not follow internet advice
Implant replacement is a personal choice, just like the original procedure
Great question Pamela. As you can see from the many responses there's an overall consensus about the stability and durability of both the saline and gel implants. Anything man/woman/machine made has a potential for failure, since nothing in our body remains stable for very long.
The implant replacement issue was very prevalent during the early years of breast augmentation and before the newer 'models' were redesigned after the 10 yr moratorium by the FDA. Back then we had thin walled incompletely polymerized gel implants, sometimes enclosed in another implant of saline (the double lumen implant) and both had the problem of capsular contracture. Since we didn't know what was causing the contracture, we assumed it was silicone, and the implant was often removed with the capsule. Those were the years when multiple types of synthetics were used and multiple surfaces applied to the implants including Dacron patches to keep them from 'moving around' - a concept borrowed from hip replacement prosthesis - not exactly applicable to breast 'natural' function.
Today, with the advent of endoscopic breast augmentations and thicker implant shells, cohesive (better polymerized) gels the intrinsic problems contributed by the implant are much less. A recent disclosure that cotton (one of the most reactive of substances within the body) may be the main culprit in capsular contracture has led many of us to dispense with using any cotton gauze within the wounds, to dry any fluid drainage or use as dissecting tool (as we were taught in years past) and the capsular contracture issue is much less (from 20% to less than 0.5%) than it used to be, and implants are not removed as often.
I am starting to see patients that have had submuscular implants with several muscle induced deformities come to the realization that a submammary gel implant can give them a more natural cleavage with less 'folding' 'creasing or rippling' and enhance the overall breast texture than it ever was with saline, especially if the implant pocket was small to begin with, so I'm removing saline implants and replacing them with gels and improving the patient's overall satisfaction with their breasts.
I suspect that when the current trend of submuscular placements begins its reversal as it did 20 yrs ago when we had to use the pectoralis muscle in breast reconstruction and became disillussioned with the abnormal movement and lack of cleavage, we will see more women ask for cleavage and texture, bounce and giggle than they had in the past. The best way to achieve that will be with submammary gels and a resurgence of primary gel augmentations will occur. Time will tell.
Ultimately it's the woman who has grown accustomed to her implants as her own breasts that will decide what happens. The body image incorporation is so strong as to produce the same emotional effect as a mastectomy when an implant deflates. The idea of 'having to go through that again' will ultimately determine the decision to reach for the non-deflatable gels and get on with their lives.
I hope this helps.
How Long Do Breast Implants Last?
Breast implants can last a lifetime, but unfortunately there is no way to predict how long any particular one will last. We know from experience that current silicone gel implants are much more durable than ones placed twenty years ago.
When saline implants leak, you will usually know fairly soon that there is a leak because the breast will start to get smaller. Over a five-year study period in my practice, the deflation rate for saline implants was 0.4% per implant or 0.8% per patient/per year. This is in general accordance with the literature. To achieve these rates, it is known that saline implants should not be underinflated. For example, a 300 cc saline implant should not be filled to less than 300 cc. If it is, the deflation rate greatly increases. In practice, I usually fill saline implants about 10% above the nominal size. This keeps the shell from folding, decreasing the risk of shell-fold failure. It also makes a saline implant smoother and not so likely to feel ripply through thin skin.
The leakage rate for gel implants seems lower, with the Mentor core study showing a 0.5% rupture rate at 3 years. For re-augmentation patients, the rate was 7.7%. It was noted that the main reason for re-operation was capsular contracture. The core study found a capsular contracture rate of 18.9% over a 3- year period. Capsular contracture prevention is obviously a very worthy goal, but the exact cause of contracture is not known. Current theories point more and more to the colonization of the implant surface by bacteria that are found in breast tissue or on the skin. These bacteria protect themselves by forming a biological shield known as a biofilm. This film prevents the immune system's white cells from fighting the bacteria. These bacteria are also resistant to commonly used antibiotics.
The use of an antibiotic and betadine solution to irrigate the pocket during surgery helps greatly to reduce the incidence of capsular contracture. The use after surgery of antibiotics effective against the particular organisms implicated in capsular contracture has also been advocated. A "no-touch" technique during implant placement means that the surgeon uses new powder-free gloves and touches nothing but the implant during insertion. This decreases the risk of getting bacteria on the implants. The use of the new Keller funnel allows placement of silicone-gel implants through a smaller incision without trauma to the implant as well as maintaining a "no-touch" technique.
Finally, a meticulous dissection with monopolar forceps cautery under direct visualization as introduced by Dr. John Tebbets of Dallas, and used in my practice for years, allows pocket dissection without any bleeding. Case studies have shown that having little or no blood in the pocket also correlates with a reduced contracture rate. I and others using similar techniques have noted capsular contracture rates for both saline and gel implants between 1-1.5% over a three to five year period.
The FDA ensures that women having breast augmentation are informed that implants are "not lifetime devices" and that re-operation with or without implant replacement "will be likely" during your lifetime. There is, however, no recommendation based on any studies that implants should be changed at any particular time interval, such as 10 or 15 years. If a woman is having no problems with her implants, then there is no reason to re-operate simply to change them.
To monitor your gel implants, an MRI is recommended periodically, since it can be difficult to know if a gel implant has ruptured by physical observation or examination. The treatment for a deflated saline implant or a "silent rupture" of a gel implant is to replace the implant. The replacement operation does not have the same recovery period as the initial placement, since the pocket is already formed. However, if years have passed since the initial operation and skin has stretched, or if a larger implant is desired, additional surgery on the skin envelope or breast pocket may be needed.
Generally there is no expiration date.
As most of the other doctors have mentioned -
Implants do not necessarily need to be changed out at any interval. The numbers you hear people talk about are based on averages of people that have had the implants replaced.
The most often cited number is (again... on average) every 10-15 years people will need an additional operation for their breast augmentation. Now that number is based on surgeries for all reasons - ruptured implants, want larger implants, have capsular contracture, just don't want the implants in anymore.
In addition that 10-15 year number is based on the older implant shells. The new formulations are more resistant to rupture and as the science of how to avoid capsular contracture gets better you will probably see that number increase.
In your situation however, it is never normal to feel air pockets or have redness associated with your implants and you should see a board certified plastic surgeon today. If you can't get to your plastic surgeon you should probably go to the emergency room. The situation you are describing is possibly that serious.
Usually 10-15 years
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.
Do I need to exchange my implant?
Implants are a well constructed mechanical device, but like any device they may eventually fail.
In saline implants the rate of rupture has been quoted somewhere between 1%-4% per year. Basically the older the implant the higher the risk of rupture.
With a saline implant, If your happy and you look good my philosopy is if "it's not broke don't fix it" If the shell of the lmplant leaks it just releases salt water which is what your body is made of. You'll know if you leak because the breast will get rapidly smaller. I have patients that have gone more than 20 years with intact saline implants.
With respect to silicone implants the new generation of cohesive implants have a thicker shell and a thicker silicone. All early indications are that they should last longer and behave better than the older generation of gel implants and may even last longer than saline. This longevity is still being evaluated.
Because you can't always tell if a silicone implant is leaking on physical examination (the gel just stays inside you) the FDA currently recommends women with gel implants get an MRI to look at the implants 3 years after surgery and every 2 years thereafter.
Because the rate of capsular can go up if an implant leaks I would rather see my own patients change a gel implant before they find a leak on the MRI. Exchanging an intact gel implant is a short procedure with little down time. Removing a tight contracted and leaking implant is much more involved. I use the conservative estimate of 10 years presently but I expect to increase this as we get more information on the lonevity of our new generation of silicone gel implants.
Because you are having a problem under your breast I would recommend you follow up with your Plastic Surgeon as soon as possible to be evaluated.
Hope this helps.
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.