Is it better to remove implants sooner or later?

Question

I’ve had silicone textured implants for 20 years. They look natural and are beautiful. However, I lost sensibility on half of my left breast and it’s kind of painful. Therefore, I’ve always thought that the day I had to replace them I would choose to remove them completely without mastopexy. Although the implants are intact now I know that someday soon I’ll have to make this decision. I’m wondering if it’s better to remove them now that I’m 41 than wait to get older and have less elastic skin.

Alan Gonzalez, MD, FACS · Answer

Hi @Gregarious199024, thank you for your question. It is best for your health to remove the implants as soon as possible, as you have had them for 20 years and the recommendation is to replace or remove them once they are 10 years old. It is important to keep in mind that after implant removal, the skin and breast tissues may be stretched or sagging, which can result in a less than ideal appearance. If you decide to undergo a lift, the most optimal and aesthetically appropriate option would be immediate reconstruction with the BRALAN technique (Breast Reconstruction Anatomical Lift Augmentation) combined with a breast lift to provide a natural and lifted appearance. Consultation with a plastic surgeon experienced in this procedure is essential to ensure optimal results. I link a video that sheds more light. Best regards.

Alan Gonzalez MD, FACS. Member of the American Society of Plastic Surgery (ASPS), Member of the International Federation for Adipose Therapeutics and Science” (IFATS), Member of the Colombian Society of Plastic Surgery (SCCP).

Alan Gonzalez MD, FACS. Member of the American Society of Plastic Surgery (ASPS), Member of the International Federation for Adipose Therapeutics and Science” (IFATS), Member of the Colombian Society of Plastic Surgery (SCCP).

Shaher W. Khan, MD · Answer

Hello, thank you for your question. I have attached a video in detail that specifically answers your question. You're 100% correct in regards of your skin elasticity--meaning that the likelihood your results will look more aesthetically pleasing after removal are better than someone who is 65, for example.

Philip J. Straka, MD, FACS · Answer

Good question! Typically, the breast tissue the skin tightens to some degree for many patients. following breast implant removal. This can occur for months to even one year after breast implant removal surgery. The degree of skin retraction is highly variable from patient to patient due to several factors such as patient age, the thickness of one's deeper layer of the skin called the dermis, and skin elasticity. The fact that you are only 41 years old likely increases your chance of having better skin elasticity than when you become older, as with age, the dermis typically thins and one's skin elasticity typically decreases. Another reason to consider removal of your implants soon is the fact that you stated that you have had textured silicone implants in place for 20 years. The older the implants, the greater the risk of rupture and leak of the silicone into tissues surrounding your implants. In addition, you may choose implant removal due to the risk of Breast Implant Associated Lymphoma with older, textured breast implants. You can refer to my website (drstraka.com) to see examples of breast implant removal patients of various ages who have undergone their breast implant removal. These are procedures which I personally have performed for over 25 years. I wish you the best of luck!

Daniel Barrett, MD · Answer

Dear Gregarious199024,
I recommend my patients to change implants every 10 years in order to reduce the chance of possible complications. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Gary M. Horndeski, MD · Answer

Textured implants have been associated with BIA-ALCL and it is recommend that they be removed. Also, removing implants will result in hanging skin and you will need a breast lift. The technique I recommend is explantation and lift using The Bellesoma Method. The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Camille Cash, MD · Answer

As you are experiencing changes in your breasts (sensitivity changes and pain) it would make sense to address these concerns now.  Or at the very least visit with a board certified plastic surgeon near you for an evaluation of your symptoms.

Connie Hiers, MD, FACS · Answer

The average lifespan of the implant bag is 20 years. With saline, I have seen some at 40 years that still looked great.  If you have 20-year-old gel implants, they need to come out because of the gel bleed.  New gel implants were not available in the US until 2007.  Your other option is to consider going with something smaller and doing the lift if needed. Unless you have gained weight and more breast tissue in the past 20 years, you may not be happy without implants. Going smaller does make an easier change. Health wise, you might want to remove or exchange them before the mid 60's if you have no health issues now.  However, I have done ladies in their 70's and 80's and they did very well.  I recommend everyone to remove the old gel implants.

Mats Hagstrom, MD (license on probation) · Answer

Not sure why you want to remove your implants if they are serving you well. At 20 years the implants are pretty fragile. Most people are not aware when silicone implants rupture. Even with MRI which is the most accurate radiographic study false negatives happen frequently.
Exchanging implants is really easy if no other work is being done and if bigger implants are not being used. Swapping implants can be done in 30 minutes and can be done using local anesthesia( if other work is not being done) 
I generally encourage people to not make their own assessments and not make their own medical decisions without appropriate guidance. 
I have seen too many women just like you who were done with implants only to have major regrets a few months after removing the implants. 
Reaugmenting after explanation is NOT a good idea. 
If your provider is still around then talk to him or her. If not schedule a couple of in person consults with other providers so you can get some guidance regardless of what you decide. 
There is no correct answer of when to remove or exchange implants. Each provider will have their own opinion. 
Best,
Mats Hagström MD

Is it better to remove implants sooner or later?

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