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

Implants generally don't get hard however the capsules which form around the implants can get hard.
To give an oversimplified analogy, it is like jeans that shrink around your thighs and make them feel hard.
Capsular contracture is a poorly understood phenomenon.

It is a very good question to ask. There was a multitude of studies done to find out if there were any saftey issues with silicone implants. None of the studies were able to show any significant association of silicone implants with any particular disease or problem. Thus, silicone implants are considered to be very safe.

One of the complications of breast augmentation, and the one your question alludes to, is something called capsular contracture. Once an implant is inserted into the breast, the body forms a scar around which we call a "capsule." Usually, this stays soft and does not cause any problems. However, in a small percentage of women for unknown reasons, the scar starts to become hard and tight. When this happens, it is called capsular contracture. When it happens, it can cause the breast to feel hard and look distorted. This can happen whether you have saline or silicone implants.

It can be taken care of if it happens. If capsular contracture does occur, the solution is usually to re-operate. The incision used in the first operation can usually be re-used. Then, all of the scar and the implant is removed. I prefer to replace the implant with a brand new one. Once the hard scar is removed, the breast usually remains soft. Rarely, in a small percentage of women, it can happen again.

In summary: Silicone implants are safe. All surgery has its complications. Capsular contracture is one possible complication of breast augmentation. It can happen with both saline and silicone implants. The vast majority of women who get breast augmentation do not get capsular contracture and are very happy and satisfied with their surgery.

The implants themselves do not get hard. A rare, but real consideration is capsular contraction. This is caused by your body forming scar tissue around the capsule. As the scar contracts, the implant is squeezed and may feel hard. The hardness is actually due to the scar tissue, not the implant.

The body normally forms a thin layer of pliable scar tissue around any foreign substance placed into it. This occurs whether the device is an artificial knee, artificial hip, a prosthetic joint or a breast implant. This process is beneficial because it keeps the implant in the space created for it - the pocket made at the time of surgery. Sometimes this scar layer, or capsule, will contract around a breast implant and render the breast hard in consistency. This is a biological and not a surgical cause of breast hardening and essentially represents an over-reaction by the immune system. The shape of the breast may change if this process becomes more advanced. In extreme cases the condition may be painful enough to require surgical correction by complete removal of the scar capsule and replacement of the implant. This treatment is usually successful although recurrence of dense scar tissue around the implant can happen in some women, particularly those in whom the process affects both sides. The cause of excessive capsule formation, or capsular contracture, is not known.
So it is not the implant which can get hard, but the surrounding capsule which may squeeze the implant inside.

The implants themselves do not harden. They remain the same consistency and size over time. The capsule around the implant can cause a capsular contracture. When this happens you could experience hardness of the implant and sometimes change in implant position and shape. This is less common with silicone implants especially when placed beneath the muscle.