Life Expectancy of Your Breast Implants
Did you know that if your breasts implants are over 10 years old your risk of implant rupture has now risen to an appreciably higher level than prior to their 10th “birthday?” While I have seen some last 25 years, statistics show that after 10 years you should at least entertain an implant exchange. Why is it so important? There are three reasons and they are dependent upon the type of implants you have. Only one of the three poses a potential health risk. The other two involve either opportunity cost or operative cost. Understanding your risk factor is the first step toward deciding if waiting is the right thing to do.
If you have saline implants…
Your risk of rupture with saline is no greater than that of silicone. However, when a saline implant ruptures it is obvious, leaving you with one full breast and one that is flat. Most women lead extraordinarily busy lives. Chances are a rupture will happen at the least opportune time—a business meeting, during vacation or right before an important holiday or event. Saline will not hurt you. It will simply be absorbed and/or eliminated from your body so there is no health risk. The risk is in timing. Keep in mind it takes time to get on your surgeon’s schedule, do the necessary pre-operative tests and recover. No one likes surprises on an already packed calendar.
If you have silicone implants…
While the rupture rate between saline and silicone is no different, the consequences of a potential rupture with silicone are different. First, understand silicone ruptures pose no systemic health risk whatsoever. In 1992 the FDA took silicone off the market to investigate claims against its safety. As an investigator for an implant company, I was one of few doctors able to use silicone during the moratorium. Silicone was available only for reconstruction and replacement during the course of the study which spanned 14 years. It was not until November of 2006 that silicone implants were given clearance to reenter the market. We know more about the safety of silicone implants than any other aspect of our lives…hormones, food, cosmetics, sprays—so I emphasize that silicone has been given a complete and total bill of health. You can be confident in their safety, but not their longevity. If you had silicone implants done for cosmetic, not reconstructive purposes you probably had the procedure prior to 1992 which would make them close to 20 years old. If your silicone implants are intact and you desire no cosmetic change to your breasts, the operation is simply opening the previous incision and inserting new implants after the others are removed. There is no surgical trauma and little recovery.
Ruptured silicone implants require more extensive surgery. There’s usually no reason to make an incision in a different location but the surgery itself is more complicated and correspondingly more expensive because silicone must be removed and then replaced. There are two kinds of rupture: intracapsular and extracapsular. In the former case, the additional cost is the risk, in the latter a potential health risk does exist.
In an intracapsular rupture the silicone shell that surrounds the implant ruptures but the silicone remains in the implant sack or capsule. In this case the implant and the implant material and all scar tissue are removed during the revisional surgery. It is very important that no residual silicone is left behind in the breast pocket because it puts the patient at risk for capsular contracture or hardening of breast. Should I feel there is some silicone leakage OUT of the shell but inside the scar tissue capsule, I prepare the patient for the use of a Strattice® porcine implant which creates an internal bra that significantly reduces the risk (less than 1%) of capsular contracture.
In an extracapsular rupture the silicone has escaped from implant shell and has also broken through the sack or capsule that the body has built around the implant. This is most accurately diagnosed by an MRI or physician exam. In this case the free silicone may have gained access to your breast tissue or axilla (armpit.) It is incumbent upon the surgeon to do an extremely thorough exploration and removal of all silicone that has entered the breast or armpit areas. Throughout my career I have seen only a few cases where the silicone was so diffusely associated with breasts and chest wall areas that not all the residual silicone could be erased. These were generally second generation implants where the shell was especially thin and the implant material was more liquid than gel. The body’s natural reaction is to protect itself from anything foreign and so it “walls off” the free silicone. This can interfere with breast exams and mammography screening. In my opinion this is the only significant downside of silicone breast implants—the potential health risk posed in interfering with breast cancer surveillance. Todays implants—especially those developed by Allergan Medical—have a double shell and if cut, the implant made of highly cohesive material acts like Jello, showing some motion but highly resistant to extruding.
This information is not intended to alarm but rather alert breast implant patients. I hope it serves as an important reminder that implants are not lifetime devices and understanding the ramifications of being on borrowed time can save you the inconvenience, cost and potential health screening risk. Sometimes being prepared is the best medicine.
Return to the Breast Augmentation page.
View our Breast Augmentation Before-and-After Gallery.
Follow Us