When to Replace Implants?

I had augmentation in my early 20s but am now 45. I have been happy with my procedure but am beginning to notice hardening in my right breast. At what point do I begin to consider having the procedure redone? I am also curious to know if a second surgery is more or less difficult than the first. How different should I expect the costs to be? Given that my surgery was twenty years ago I can help but wonder at the evolution of both implant and procedure.

Doctor Answers 9

Replacing Implants

I agree with Dr. Kim.  It sounds like you have a capsular contracture.  Replacement is appropriate.  The complexity of the case increases if there is a downsizing of the implants because a lift may be necessary in addition.  The cost vary from practice to practice.  



Implant exchange

There are couple reasons to change implants: 1) implant rupture, 2) capsular contracture, 3) wanting to change implant size to larger or smaller.  From your description, you are experiencing capsular contracture, formation of scar tissue around the implants.  Depending on the degree of capsular contracture, you may want to change your implants.  I usually recommend my patients to exchange their implants when the implants become hard and cause discomfort to them and/or when breasts change shape due to the capsular contracture.  In regards to recovery, your pain/recovery will be easier than the initial breast augmentation if your implants had been placed submuscuar plane or subglandular plane as long as you want to keep the implants in the same plane.  I would think the cost of the surgery has gone up since 25 years ago. Lastly, please visit with well-experienced, board-certified plastic surgeon for your surgery.  Best wishes.

Sugene Kim, MD, FACS
Houston Plastic Surgeon
4.7 out of 5 stars 76 reviews



The removing and replacing of implants depends on each patient’s needs. If you are having hardening of your breast it can be a good reason to remove them. The procedure is a little longer but the pain should be a little easier. The cost differs on each practice going for a consultation that question would be able to be answered.



Stuart B. Kincaid, MD, FACS (in memoriam)
Beverly Hills Plastic Surgeon
3.3 out of 5 stars 9 reviews

When to replace breast implants

We have a saying in the South:  "If it ain't broke, don't fix it."  Still, twenty-five years is a long time to have had an implant.  I am assuming that you have silicone gel implants since that was the predominant implant used twenty five years ago.  The fact that one is now starting to get firm may be an indication that that implant may be leaking and your body is reacting by forming more scar tissue around it.  Even if it isn't leaking, it might not be a bad idea to change out your implants before they break rather than waiting until they do.  When those older style implants break, they tend to be gooey silicone gel rather than the more cohesive silicone gel available today.


You asked if the second surgery is more difficult than the first.  From the surgeon's perspective it is hard to compare since they are different surgeries.  From the patient's perspective, since your tissues have already been stretched to accommodate the implants, this does not need to be done again.  That should certainly help to make the second surgery easier.

Edwin C. Pound, III, MD
Atlanta Plastic Surgeon
4.6 out of 5 stars 25 reviews

When to replace breast implants

You did not mention whether your implants are saline or silicone (silicone implants were available for breast augmentation until 1992; were not available for augmentations between 1992 and 2006, and returned to the market in 2006).

If you have silicone implants, hardening of the breast (capsular contracture) is one of the signs of a potentially ruptured implant.  It was generally recommended that the silicone implants used in the early 1990s be replaced approximately every ten years (even if they were still intact).  If your implants are saline, they can be left in place until the cosmetic changes to the breast bother you.

Removing a ruptured silicone implant placed in the 1990s requires removal of the scar tissue around the implant as a unit with the ruptured implant - a more extensive procedure than the original augmentation.

If your implants are silicone, I would recommend that you consult with board-certified plastic surgeons who are experienced at removal ruptured silicone implants.

Good luck.

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

Implant replacement

On average most women have to have their breast implaced replaced after 10-15 years, but if you are still happy with your results than there is no need to undergo a second surgery.  These numbers are only given as a guideline representing the common trends. However, I would see your plastic surgeon concerning the firmness along your right breast.  It may be a capsular contracture that may require surgery to fix.  I hope this helps and good luck.

Kindest regards

Nail. J Zemme.

Neil J. Zemmel, MD, FACS
Richmond Plastic Surgeon
5.0 out of 5 stars 107 reviews

Implants do not need to be replaced until there is a definite reason to do so.

Even 25 years after augmentation, if you are pleased with the breasts there is no need to replace the implants.  A secondary operation is a bit more complicated than the original and you open yourself up to the risks of any operation-infection, hematoma, etc. 

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 36 reviews

Implant replacement

If you are experiencing some hardening of your implants, you may be experiencing some scar tissue forming around your implant (also referred to as capsular contracture).   What exactly will be involved with your revision surgery will depend on how your breast looks currently.  In addition, what are your cosmetic goals with respect to your breasts? So a physical exam would be needed to make any suggestions of value.  Please visit with a board certified PS to learn more about your options.  Best of luck. Dr. Basu Houston, TX

C. Bob Basu, MD, FACS
Houston Plastic Surgeon
4.7 out of 5 stars 211 reviews

When to replace your Implants?

Thank you for your question.
Generally, I say "when it isn't broke, don't fix it" but if you are starting to experience hardening of the right breast, then it may be time to look into having surgery to remove and replace your current breast implants.  if you have silicone gel breast implants in place and opt  not to undergo removal/replacement of the breast implants,  you should at least undergo MRI study of the breasts to rule out leakage.
Normally, the recovery for this procedure is easier for patients than the first breast augmentation surgery. This is especially true if the same breast implant pocket is utilized during the revisionary breast surgery.
It would be in your best interests to meet with with board certified plastic surgeons to get good advice regarding revisionary breast surgery and  learn about the “evolution” of the breast implants, options available, as well as the potential risks/complications associated with revision breast surgery. Before selecting your plastic surgeon ask to see lots of examples of their work.
Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 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.