Do Silicone Breast Implants Harden over Time?

Capsular contracture remains the most common reason for women having a revisionary breast surgery.

Even when a surgeon does everything perfectly, employing all we know about avoiding contractures, it can still happen.

It is normal to form a capsule - a thin membrane - around the implant. It should stay thin and pliable. But if there is inflammation around the implant, it can thicken, stiffen, and tighten.

The key is to avoid the inflammation. Many things can cause it, such as trauma at the time of surgery and bacteria. Studies today demonstrate that bacterial contamination may be the most profound avoidable cause of contracture.

Your surgeon should employ a method that minimizes trauma to your tissue, lessening the duration of your mobility and inflammation, thereby allowing you easier motion earlier on. He or she should also give you approriate antibiotics as well as antibiotic irrigation of the implant and pocket during surgery.

And one more thing --your quesiton implied a difference between saline and silicone with regards to capsular contracture. While that may have been true with implants in years gone by, that has not been found to be true with the current generation of silicone implants.

Find a surgeon that is well-versed in the issues of contraction and can explain to you why they believe it occurs and how they avoid it. But be careful of those that say "i never get it!" That's impossible! You want your surgeon to demonstrate both a healthy respect for this problem as well as a thoughtful strategy for how they deal with it.

Thank you for your question.The hardening that can occur over time that you are describing is referred to as a capsular contracture, a complication that can occur following a breast augmentation.  Because the human body considers an implant (saline or silicone) foreign object, once a breast implant is placed, the body will form a thin layer of scar tissue around the implant called a capsule.  This capsule is essentially a barrier that exists between the body tissues and the 'foreign' implant.  In most patients, this capsule remains soft and you would never know, you would not have any issue or cause for concern.  In other patients, however, this normal bodily response can be heightened and the scar tissue that has grown in thickness can tighten around the implant causing implant constriction, hardening of your breasts and/or breast distortion (in size and/or shape).  I think it is important to note that a capsular contracture can develop with both saline and silicone gel implants, but that these rates of capsular contracture development are low.  Capsular contractures are also less likely to develop with silicone gel implants placed beneath the muscle.  Breast massages can help to prevent capsular contracture development and, like always, it is always advised that patients speak address any concerns and complication risks with their operating surgeons.I hope you find this helpful!

Implants do not harden over time. They remain the same in texture and size (unless they rupture). However sometimes the tissue surrounding the implant can thicken and compress the implant. This complication is known as capsular contracture. It is believed that one cause of capsular contracture is infection. 

All implants harden over time. The percentage for capsular contracture is 1% per year. All implants need to be replaced within 10-15 years.

This is what you are referring to. Capsular contracture happens to some extent in all patients who have implants. There are different grades and what you want is a Grade I. The significant contracture happens in about 7.5% of saline augmentations and about 9% of silicone augmentation. This is some new data from one of the implant companies.

To try to avoid this there are a lot of little things that are done in the operating room and after surgery the patients are instructed to massage vigorously to prevent this.

Hope that helps