Over the years, there have been a number of concerns about breast augmentation surgery and breast implants. Back in 1992, the Food and Drug Administration pulled silicone implants off of the market, amid a sea of concerns about their safety. Silicone implants were reintroduced in 2006, with a number of rules from the FDA — specifically the warning that implants aren’t meant to last a lifetime and that they might need to be replaced at some point or another.

While the FDA is right to be cautious about implants, there is plenty of confusion over its declaration that breast implants aren’t built to last forever. While some people assume that their implants have a sell-by or use-by date, after which they should be replaced, the issue is actually a little more complicated than that. It is possible for your implants to last you the rest of your life. If they don’t, you’ll be able to tell pretty much right away that it’s time to replace them.

Ruptured Implants

If one or both of your implants rupture, you’ll most likely decide to have them replaced. What happens when an implant ruptures depends on the type you have. If you have saline implants, the results of the rupture are usually pretty obvious, as all the salt water seeps out of the device and your breast deflates. You don’t have to worry about the saline, as your body will absorb naturally.

When implants made from silicone rupture, the results might not be as obvious. In some cases, the silicone gel is thick enough to stay inside the implant and you might not even know about the leak until you decide to have the implants removed for another reason. The silicone gel might seep out of the implant, but remain trapped inside the capsule of tissue that surrounds it, causing no symptoms.

In other cases, the silicone can seep beyond the capsule and cause changes to the breast. In that case, you will most likely want to have the implants removed and replaced with new ones. Signs of a silicone implant rupture include pain in the breast, a change in the breast’s size or shape, and hardening of the breast. If you have any of those signs or are concerned about other changes in your breast, it’s best to call your surgeon immediately.

Capsular Contracture

In some cases, the implant and the capsule of tissue around it can become hard, a condition that’s known as capsular contracture. Capsular contracture can occur almost immediately after surgery, or it can develop years and years later. The condition can occur on just one or on both breasts.

According to the FDA, there are four stages of capsular contracture, I through IV. In the first two stages, the breast usually looks and feels normal. In the latter two stages, III and IV, the breast is firm or hard to the touch and looks unusual. In stage IV, the breast is also usually painful.

Baker stages III and IV often call for the replacement of the implant. During the surgery, the doctor will also remove the capsule that surrounds the implant. The condition can recur after replacement. To reduce chance of recurrence, a surgeon might recommend waiting to replace the implants after removal

You Want Something Different

Sometimes the reasons for wanting to replace breast implants are simple. You might just want something different, such as smaller or larger implants. Your body will change shape and size to some degree as you get older and the implants that worked well when you were 25 might not be so flattering at age 40.

Checking Up on Your Implants

Usually, if something goes wrong with your implants, you’ll be able to tell. But, you might decide to have your surgeon check up on them after some time, even if there are no visible signs of a problem. In the case of silicone implants, the FDA recommends having an MRI every three years or so, but not many women do that. At the very least, you might want to see your surgeon for a follow up a year or so after you receive the implants, then again about a decade after the surgery, just to confirm that they are doing all right.

Of course, if you have problems before then or change your mind about the implants, it’s always a good idea to schedule an appointment with your surgeon right away.

At the Bitar Cosmetic Surgery Institute (http://www.bitarinstitute.com), in the Washington, DC area, Dr. George Bitar has performed thousands of plastic surgery procedures, including breast implant removal and replacement. If you think it’s time to replace your implants, schedule a consultation by calling the practice at 703-206-0506 today.

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George Bitar, MD, FACS

George Bitar MD, FACS, is an award-winning, fellowship-trained, board certified plastic surgeon who has performed over 5,000 cosmetic facial and body procedures.

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• Is It Time To Replace Your Implants? - October 9, 2017