There are several reasons why a woman with breast implants may require additional surgery. Certainly a leaking implant is one of them and the risk of a leak is relatively low in the first 10 years after surgery. As the implants age, the chance that they will leak is higher since, like all things, the older it gets, the more likely it is to break. I'm not sure where you got the figure of an average implant lasting 25 years, as I'm not aware of that data and I believe the average is probably shorter than 25 years.Women with silicone implants, as yours are, have a more complex decision making process than women with saline implants. In the case of a saline implant, I tell my patients "Put them in and forget about them. If they look good and feel good, they are good." In other words, with saline implants I don't advocate for prophylactic exchange of the implants unless the woman is having breast surgery otherwise and the implants are more than 10 years old (for instance if she needs a lift). In the case of silicone implants, it is very difficult for a woman and her surgeon to determine whether the implant has ruptured, which is why the FDA recommends that women with silicone implants have an MRI every few years to check for a leak. If a silicone implant has leaked, it should be removed and, depending on the patient's preference, can be replaced. Many women don't have the MRIs as often as the FDA recommendation, but the older the implant is, the more important it is to look for a leak.A ruptured silicone implant is more difficult to remove than an intact one, as it often involves removal of the capsule surrounding the implant (the rim of scar tissue). This is done to try to contain the silicone gel that has leaked and ensure that most of it has been removed. Having said that, removal of a ruptured silicone implant can be done at any age, even for a woman in her 80s, as long as the patient is in reasonably good health to tolerate surgery.To recap, I don't think it's necessary for a young woman with 6 year old implants to have them removed for fear of what may happen in 10, 20, or 50 years. If you like your breasts, leave your implants for now and consider having an MRI to check on them for leaks. If you're spending a lot of time worrying about what might happen with your silicone implants, you may consider talking to your doctor about switching them out for saline at some point, but you very well may find that the saline implant doesn't feel as much like a natural breast as your current implants.
