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Do I need to change my breast implants after 10 years?

There appears to be a significant misunderstanding, or misrepresentation of the FDA data when breast implants were again brought back for general clinical use around 2011. With each new generation of breast implants advancements are made and this has been especially true of their durability. Still implants are not permanent devices. It would be terrific if one set of implants could last forever, but there is a rate of breakage of silicone or saline implants. The breakage data for implants are averages of large populations of patients, not a set number of years that dictate changing your implants.
 
   If you follow augmentation patients for 10 years you may find 20% may request a revisional surgery, but many are not because their implant broke. Some patients may have hardening of the scar tissue around the implant (capsular contracture). Some patients may want a breast lift or a change in the size of their implants even though the implants are intact. It is reasonable to consider exchange of the implants since they are undergoing a surgery to revise the breast shape or size, especially if the implants are older, but it isn’t a requirement in many circumstances. The reality is the FDA and current research data concerning implants are probability data based on the specific group evaluated. So if we say implants my have a breakage or deflation rate around 10% at 10 years that means 90% of people don’t have a broken implant and any one individual may not have an implant break for 30 or 40 years, no one knows for that individual patient. Of course , if your saline implant deflates or your silicone implant is found to be broken at that point in time it’s a 100% rate for you. So given the data if everyone had surgery at 10 years post implantation then 90% of those patients didn’t have a broken implant, and if no other issues why should they spend money for the surgery as well as time off of work or any minor risks of the procedure itself. 
 
   If a saline implant fails it is not subtle; the breast shrinks in size, gets softer, and may become more ptotic which mean droopier. Silicone implants can break, and you may not know unless you have a high resolution ultrasound or MRI (magnetic resonance imaging) scan. While these tests are not 100% reliable their detection rates of broken implants are very high and the best we have as non-invasive tests to look for broken silicone implants. If your implant is studied at some point in time and the studies are normal then you avoided a surgery which can be a good thing.
 
   Having been in practice for about 30 years now I personally have thousands of patients that have had augmentations or breast reconstructions with implants. If after 10 years if every one of those patients returned to get new implants I’d have a full operating schedule just revising old patients. While great for a practice’s bottom line I’d be operating on a ton of patients who didn’t need the surgery. The data just doesn’t support the need for all those patients to get re-operated on. Why should they pay for the new implants, new surgery, and take even the minor risk of surgery. Over 40 years that would be 4 surgeries. Now of course if the patient has other desires about their breasts, or want to change the shape or size then sure change the implants out if they are older.
 
   Occasionally I do meet a patient that just can’t get this 10 year data point out of their head so they just worry more about the idea of an implant breaking. In those circumstances I try to get them to understand that the numbers are just statistics, and if they really feel the need to do surgery they can, it’s their body and life plan, but then they may want to at least wait till the implants are 15 or 20 years old when the risk of a broken implant has gone up enough that changing makes more sense. Plus for most people after 20 years they are certainly more likely to have other reasons to adjust their breast size or shape. This way they may have 2 or 3 surgeries in a lifetime not 5 or 6. Hopefully this has shed some light on the indications for changing out breast implants and trying to use data scientifically and logically to make the best decisions for you. Don’t just let someone tell you to change your implants at 10 years until they can back that up with scientific explanations that make sense to you.

 

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