Breast Augmentation Revision – When Do I get My Breast Implants Replaced?

Patients often ask me when they are should have their breast implants replaced. Implants only need to be replaced if there is a problem with them. On average, 20 percent of patients will need a revision or replacement surgery by 10 years.

How do I know if I have a problem with my breast implant?

Yearly breast exams by a physician are important, one for examining the implant and two, for detecting any abnormal breast tissue. I also encourage patients to perform monthly self-breast exams, looking for any bumps or hardening of the implant. The FDA recommends patients with silicone breast implants to screen their implants for silent rupture at 3 years after the initial surgery, and then every 2 years thus after. In a practical sense, most women are not routinely screening their breast implants with MRI due to cost.

What are some signs implants may need replacement?

I often hear women telling me that they were told they would need their implants replaced every 10 years. That’s not true. I would only replace the implants if there are problems. First the breast and implant needs to be examined. Second, saline and silicone ruptures appear differently. If a saline implant ruptures, the breast will become smaller. In this case, the implant needs to be removed or replaced. If a silicone implant ruptures, a patient may not initially be aware of it. The outer shell of the implant may have a silent rupture, only detectable by MRI. Newer generation breast implants with cohesive gels (to prevent leakage into surrounding tissues) still can have silent ruptures or tears in the outer shell. Older generation breast implants, with silicone gel that would “leak” into surrounding tissue may be easier to detect rupture on mammogram or ultrasound. Patients may also feel or notice a change in their breast tissue. Any time a silicone implant ruptures, it needs to be replaced.
Other indications for implant replacement include capsular contracture or infection. A capsular contracture occurs when the capsule, or scar tissue, which naturally forms around a breast implant becomes thick, hard, and often painful. As the condition worsens, the breast may become distorted or change shapes. If capsular contracture develops, it’s time to have the capsule removed and the breast implant replaced.

How long do breast implants last?

Most women have long lasting breast implants without complications. Recent FDA reports show approximately 20% of patients undergo reoperation within 10 years of their initial surgery. Some implant manufactures now offer lifetime warranties on implants and insurance plans to help cover future expenses associated with breast implants replacement surgery. I tell my patients that at some point in the future they will likely require a breast implant replacement or revision surgery. If the implants and breasts are doing well, I would not replace the implants.