Should I have my implants removed? They are 27 years old.

If you aren't have any issues, there is no reason to remove them.   I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified, Double Fellowship-Trained Beverly Hills Plastic Surgeon

The short answer is "that depends."  If you are bothered by the larger size and drooping of your breasts with age and weight gain, it would be reasonable to have your implants removed and you may consider a breast lift (without photos it's hard to make a definitive recommendation about whether a lift is necessary).  If your breasts are bigger and sagging but you're not interested in surgery, then whether you have the implants evaluated would really depend on whether they're saline or silicone.  If they're saline, there's no reason to remove them other than what I noted above.  If they're silicone, you should see a plastic surgeon and consider an MRI to see if they've ruptured.  A ruptured silicone implant should be removed and an MRI is the best way to evaluate the implants, as most ruptures are silent (the breasts still look and feel normal making it difficult for the patient and surgeon to appreciate that anything is wrong with the implant).

Removing decades old implants that have ruptured is more common than you may think.  Because the only issue you are experiencing with your 27 year old implants is the weight, I would recommend that you schedule an in-office consultation with a board certified PS who performs hundreds of breast procedures each year to discuss your best options.Usually removing the implants and performing the lift at the same time makes the most sense as some patients clearly need a lift.  If you are borderline, removal followed by a waiting period is more reasonable.  Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

After
27 years of implants and 20 lb weight gain, it is not surprising that your
breasts have drooped.  The technique I
recommend is explantation using The Bellesoma Method.  This will reshape your breast tissue creating
upper pole fullness without implants, elevate them higher on the chest wall and
more medial to increase your cleavage. 
Vertical scars are avoided, nipple sensation and the ability to breast
feed are maintained, if not injured during your previous surgery.  The half life of implants is 9.5 years, so
you have done very well with keeping them for 27 years.Best Wishes,Gary Horndeski, M.D.

Dear capuli,as long as there are no issues with your implants, you should not remove them. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

The likelihood of the implants being capsulated and or ruptured are fairly high.  If you plan on keeping them then the recommendation would be to get an MRI to see how they are doing.  An exam can help determine if they are indeed capsulated.If you have that much breast tissue, the implant is probably not giving you much of a result and removal of it with the capsule would probably be the prudent way to go about things.I would recommend you see a board certified plastic surgeon to discuss your options.Hope that helps.

Breast implant shells are warrantied for 10 years in general. Ruptures or holes can develop from wear and tear that can be difficult to detect with silicone implants. If you have silicone implants, an MRI would be a way to check for rupture. Although ruptures are not dangerous in any way, we recommend removal for ruptures. It sounds like you may not need implants from a cosmetic standpoint if you currently have a lot of breast tissue. While you continue to be healthy, it may be the right time for removal.

If you are not having issues with the implants themselves there is no immediate need to remove them.  If you are considering having further surgery to the breasts such as a lift, then I would consider changing them out at that time.  I do recommend that you have your implants checked annually just to ensure there are no obvious issues.

Nothing beats consultation with a board certified plastic surgeon (b.s.p.s.).  Also more information is necessary to completely answer you.  Depending on whether the implants are saline or silicone etc is an issue.  If you have gained 20 lbs I suspect you may not feel as well as you can and would explore options to lose weight if that is an option.  Good luck and let us know what you end up doing.  

Thank you for your question and post. Generally, if the implants are not causing you any problems, then you can keep them. And this is also a personal decision about whether you want to have them or not. When the implants are removed, the capsule is removed as well.  If the capsule is very thin and immature, not thickened, not causing pain, not contracted or causing other problems, it does not have to be completely removed with the implants (en bloc) as this may cause unnecessary bleeding, pain and muscle/tissue trauma damage and injury to the breasts/chest. Be sure to see a Board Certified Plastic Surgeon who can examine you in person and take time to answer any and all questions you may have.

Sincerely,

Dr. Benjamin J. Cousins MD Board Certified Plastic Surgeon Miami/Miami Beach FL