They are soft, no leakage per MRI, folds on sides that bother me a bit but may have in new ones, as I have little fat. Plan to replace them BEFORE they leak.. Sounds like more complicated after, esp. if leaks into certain places. But several Drs (not surgeons) have discouraged me when they see/feel them. After ultra sound Dr. told me they looked only a few years old, soft, that he can see my dense tissue perfectly. Worried they may not turn out as well next time, but also about future leak
Should I Replace 27 Year Old Implants I Am Relatively Happy with to Avoid Complications of Future Leakage?
Doctor Answers 11
Age of implants do not determine the need to replace
If you are happy with your results, don't take on the added expense of new implants and more surgery and the new risks that will come with it. If your implant ruptures, your capsule will contain the filler, unless its a result of some major blunt force that tears your capsules as well. If you are going to lose sleep over it, it certainly is easier to do a upgrade before they rupture but again, it isn't absolute.
There is no reason to replace an implant of any age without clinical indication.
If you're pleased with the results of your breast augmentation and there is no clinical indication to remove the implants, there is no reason to exchange them even though there 27 years old.
My philosophy is not to routinely replace implants unless there is a reason to do so, such as proven leakage or encapsulation. Some doctors will tell you to go ahead and replace them since they are 27 years old. There is really no right or wrong answer, more a matter of the personal philosophy of each individual surgeon.
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Should You Replace Implants When You Are Not Having Problems?
Keeping in mind, that online consultants cannot be responsible for providing you with advice specific to your case, I do not read anything in your description that leads me to think that you will benefit from removal/replacement of breasts implants.
Replacing Breast Implants
Multiple studies show that the frequency of implant rupture significantly increases with implant age. The most reliable imaging modality for implant rupture detection is MRI followed by sonogram. However, MRI is not a perfect test. It would be a good idea to be followed by a Board Certified Plastic Surgeon who specializes in breast surgery. Good luck.
When to replace an implant
There is really no reason to replace the implant if it is not broken. You would be just subjecting yourself to an operation that you may not need. Of course, the implant could rupture tomorrow and force the issue. You did not mention if these were saline or gel filled implants. I would be much less inclined to replaced if they are saline and you are happy with the result. I have a patient who has had her saline implants since 1973.
Replacing old implants
For saline implants, you will know when you need to replace them since they will be deflating. For silicone implants, the only reason you need to replace them if they are unruptured and not causing a significant cosmetic problem is if you have a fear of any of the unverified problems caused by free silicone gel. If you are vigilant about any change in size, shape, or consistency of your breasts, then there is no real benefit to replacing them while there is a finite risk of some surgical or anesthetic complication. Of course, this is only a generalization and you should discuss this fully with a plastic surgeon who will be following you for a reasonably long length of time.
Robin T. W. Yuan, M.D.
Replacing Old Breast Implants
you should absolutely not replace old breast implants to avoid complications of future leakage. It your implants are not causing a problem and you are happy with them there is no reason to do anything other than enjoy them and be happy that you have no problems.
What to do about aging breast implants
Should you replace old breast implants? Generally silicone implants begin to rupture as early as 6 years after surgery. As each year goes by the rupture rate increases due to wear and tear. By 20-30 years out, most silicone implants are ruptured. Then what happens is that the body walls it off with scar tissue to contain the leak. This may or may not cause distortion of the implant.
My recommendation is that if they are leaking by observation, mammogram or MRI, then they should be removed and/or replaced. If there is no evidence of leakage, then it becomes a personal decision of what to do. It would be prudent to replace them if they are more than 20 years old before the implant actually leaks. That may prevent problems as listed above.
Should you replace 27 year old implants
If your implants are saline, you can leave them in place without worry. However a silicone gel leak is another matter. Capsular irritation occurs when the gel contacts the tissues after a leak and this leads to calcification of the capsule, tenderness, and eventual capsular contracture. Removing a gel implant after a leak involves removal of the capsule, a larger operation with more risk than simply changing out an intact implant. If you are comfortable with the risk of leaving the old gel implants in you are safe to do so, but there are consequences.