Do you have to be 22 to get silicone breast implants? Does it change depending on your state?

I'm considering getting breast implants but I am 19 and recently heard you could only get silicone implants if you're 22. A few weeks later, I read about a 19 year old who got silicone implants. I'm confused and really don't want saline implants.

Doctor Answers 16

Silicone for less than 22

There are two great options to consider:
1. IDEAL implants - these are newly released "hybrid implants" double lumen saline implants made to feel like silicone
2. I will place silicone implants in patients under 22 yrs old but first have an informed consent and have them sign a waiver that they are aware that they are being used in "off label' FDA use.

Orange County Plastic Surgeon
4.9 out of 5 stars 154 reviews

Silicone implants for under 22

We perform several thousand augmentations per year and this question always comes up. We actually called the FDA about this. They were very nice an informed us that based on the study's they reviewed that the age limit was placed but that the physician could place silicone implants in patients under this age if the doctor felt it was warranted. This would just be considered off label use of the product but completely legal. Some physicians take this to imply it's not allowed which is not true. 

William J. Hedden, MD
Birmingham Plastic Surgeon
4.8 out of 5 stars 319 reviews

Getting BBA before College

Thank you for your question!

You have the right reasons for seeking a breast augmentation procedure, and many women who are the age of 18 seek out the procedure like yourself. As such, there should be no problem when you have a consultation with a board-certified plastic surgeon while still in high school. However, the risks you may face is that if your breasts did not stop developing yet, then they may change after getting breast implants resulting in either better or worse aesthetics. Also you should note that since you are under the age of 22, you cannot get silicone implants, unless you consent for the off-label use and may have to get saline implants. You will learn more about your options in the consultation.

That being said, I believe it would be difficult to find a surgeon, undergo the procedure, and recover within 2 months assuming you end in June, and start in September. If you find a surgeon now, and book the procedure one week after school ends, then that would be better as you don’t want to rush in finding the right surgeon.

Your recovery will depend on your pain tolerance, your healing abilities, etc. Most patients are able to return to desk-jobs within 3-7 days after surgery. It would be recommended that you visit your surgeon for frequent follow-ups in the process of recovery (i.e., at 1,2,3,6 weeks after surgery, then at 3, 6, 12 months) and the more you can come before college the better, as you will get busy. This is why it is best to find a local surgeon so that follow-ups and communication is easier.

It is also recommended not to do heavy lifting of greater than 5-10 lbs for the first 3 weeks. After 2-3 weeks, you should be able to begin your light exercise routine, such as brisk walking, cycling, aerobics and lower-body weight training. You will also have to avoid any exertion or strenuous activity that requires use of the upper body (e.g., chest, arms) for at least 6 weeks. This includes but is not limited to running, push-ups, and weight-lifting. Considering this information and how engaged you are in extra-curriculars and sports, you can determine, where 2 months would be enough time for recovery.

Please note that you should find a surgeon who you can connect with, whose advice you can trust, and in whose work you can have faith, and when you do, you don’t need to look for any other surgeons. You should also look for a local board-certified plastic surgeon as it is easier to follow-up with them to make sure you are healing well without complications.

These are the steps you need to take to choose the right surgeon.

1) You should choose a surgeon who gives value to safety, and who does not rush you. This means that they shouldn’t necessarily agree to everything you say because you wouldn’t know what is best for you, so it the job of us surgeons to guide you to make decision that will minimize complications and allow you to have beautiful breasts.

2) You must verify their skills, education, and board-certification.

3) You must ask the surgeon about their experience with the procedure you want and ask to review photographic examples of the surgeon’s work. Check to see if the aesthetic ideal is consistent with what you are hoping to achieve. Make sure the before and after images have the same perspective, the same lighting.  

4) Read the surgeon’s reviews for the procedure you want on real-self and other online forums where applicable.

5) Share all your motivations for surgery, expectations and goals with complete honesty. Be as specific as you can about what you like regarding your breasts and what you don’t like. Based on this your surgeon will evaluate you as a candidate for the BBA. Ask the surgeon if your expectations are realistic and reasonable.

If they adequately verify their knowledge, skill, and level of expertise in the procedure you want, then you can be assured that you are in the right hands.

I urge you to also do your own research on the breast augmentation surgery to understand its risks and your various options with regards to implants, pocket, incision, etc.

Hope this helps.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 458 reviews

FDA recommendations

Thank you for the question. FDA recommendations state that silicone implants are best for women 22 ears of age or older. It is not illegal however, to use this but this is out of the suggestion. If you are willing to take the risk, I'm sure there are a lot of doctors who perform this with women below 22. It is always best to visit a board-certified plastic surgeon and have a full evaluation for your concern. Best of luck. Dr. Michael Omidi.

An in-person exam with a board-certified plastic surgeon is the best way to assess your needs and provide true medical advice.

Michael M. Omidi, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 92 reviews

Age and Silicone Breast Augmentation

At the present time the FDA, has recommended silicone breast implants for patients 22 years old and older.  Saline is an option for patients that desire augmentation but are not yet twenty two years old.

Craig Mezrow, MS, MD, FACS
Philadelphia Plastic Surgeon
5.0 out of 5 stars 17 reviews

Using a gel implant if less than 22 year old

The FDA recommendation is 22 so use of the implant in a woman less than 22 is considered off label.  This is a gray zone but not illegal.  If it is indicated due to your anatomy then I would have no problem using a gel implant as long as you understand the FDA guidelines.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

Silicone breast implants for patients under 22 years old

When the Food and Drug Administration (FDA) re-approved silicone implants in 2006, they were only approved for women 22 years and older.  The age (22) was determined by the ages of the patients included in the research studies performed to obtain the approval.  Use of silicone implants in women under the age of 22 is legal, but considered off-label (meaning that using them requires discussion of off-label use with the patient, and the patient and surgeon deciding that their use is appropriate).

Off-label use of drugs and devices is common (Botox was originally only approved for cosmetic use in the glabella area - between the eyebrows - but was commonly used for the forehead, crow's feet, etc.), but the patient has to be informed and understand that the safety of using that device or drug in an off-label manner has not been officially determined.

I would recommend that you consult with board-certified plastic surgeons experienced at breast augmentation, who can help you to decide if silicone implants are appropriate for you.

Best wishes.

Craig S. Rock, MD
Houston Plastic Surgeon
5.0 out of 5 stars 29 reviews

Silicone implants for patients under 22

According to the FDA, you should be at least 22 to have silicone implants.  This is a nation-wide standard.  However, some doctors are willing to perform breast augmentation surgeries with silicone implants for patients under 22 given that they sign a waiver to consent their awareness that this surgery goes against the recommendations of the FDA.  Ask your board certified plastic surgeon if he or she is comfortable using silicone implants for your breast augmentation.

Jaime Perez, MD
Tampa Plastic Surgeon
4.8 out of 5 stars 75 reviews

Silicone implants and age

Silicone implants are restricted by the FDA to women 22 and older. Other usage is considered off label.  This is due to the studies which only included women 22 and older.  The only other possible usage in those younger than 22 would be for a congenital asymmetry, or reconstruction.

Roxanne Sylora, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 18 reviews

It is not illegal to use breast implants under the age of 22

Age restriction regarding 22 years of age and gel implants is based on the fact that gel implants were reintroduced to the American market based on approval studies in women 22 years or older. Thus gel implants were approved by the FDA based on these studies and thus approved for women 22 years or older. This does not make it illegal to do gel implants in women under 22 years of age, but is considered 'off-label'. In discussion with your surgeon it is therefore legal to have gel implants performed under 22 years of age as long as there is clear informed consent and understanding regarding such off-label use. In our practice a special consent to this effect is required. 
The concept of 'off-label' applies to many drugs, medications, and devices. Another example is Botox, which was originally only FDA approved for wrinkles of the forehead between the eyes, because the approval study was limited to this area.Nevertheless Botox is used in many other areas where wrinkles are found, such as the upper forehead, crows feet etc, which are all 'off-label' uses allowable at the discretion of the doctor if he considers it safe and appropriate. In general patients should always be informed of any off-label use of a product, and of course have the opportunity to decline this off-label use.
It does not differ between states as the FDA is a federal body.

Jeffrey Hartog, MD
Orlando Plastic Surgeon
4.5 out of 5 stars 60 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.