How do I know when to replace/exchange my implant after reconstruction?

I recommend yearly follow ups for all of my breasts patients. I recommend following up with your plastic surgeon for an examination. 

A proper exam and imaging will allow your plastic surgeon to determine the cause of these spams. Implant rupture, capsular contraction could be possible causes. 

If you are having pain in the breast after reconstruction several years later, it would be a good idea to see your surgeon for follow-up. Good luck.

We don't know exactly how long silicone gel breast implants last.  In my practice, we tell patients who have silicone gel breast implants that if they ever notice a change, they should go get the breasts evaluated.  For instance, if a breast is becoming firm or painful, if a lump is noticed, or if a breast changes shape, the breast should be evaluated by someone knowledgeable about breast implants.  Also, there was a particular type of silicone implant in use around the early 2000's that was found to rupture earlier than the other implants.  It was subsequently taken off the market.  While spasms may not represent a problem with an implant, it's probably worth visiting with a plastic surgeon.  There are some good plastic surgeons in Kansas City; check one of them out!

You may be experiencing "capsular contracture".  This is when the capsule your body makes surrounding your breast implant starts to scar down, pressing on the implant and causing you pain.  Capsular contracture is more likely with silicone implants.  If you have had any radiation on that side that could be a problem as well.  See your plastic surgeon for an exam.  Good Luck