Do I have to remove my saline breast implants after 20 years?

If you are happy with the shape and feel of your breasts, there is no need to be concerned.  When saline implants leak, they deflate snd your breast size would diminish considerably.  Enjoy your results independent of the calendar.
Hope this helps.
Dr. Ali Mosharrafa

No need to remove if you aren't having any issues.  If you do see a surgeon, 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) and the American Society of Aesthetic Plastic Surgery (ASAPS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach Trained, Double-Board Certified Plastic Surgeon

Thank you for your question. The breast implant companies have warranties that last ten years but that does not mean that you have take out your implants at 10 years. The likelihood of you having complications that lead to removal of an implant become higher with more time that passes, but that also doesn't mean you need to explant them if they are not causing you any symptoms. However, you mentioned that you are having pain and that warrants you seeing a plastic surgeon so that she/he can examine you and decide what the next step in workup should be. I don't know how old you are but you could also be at the age where a mammogram (with special views for your implants) could be warranted. You should start with a plastic surgeon and the rest should be dictated based on your history and findings on physical exam. Good luck. 
Best wishes, 
Dr. Suzette Miranda