Breast implants are medical devices not designed to last a lifetime, a fact often misunderstood by the public. While they provide aesthetic enhancement for many years, they are subject to wear, tear, and biological complications. Individuals must anticipate the need for long-term monitoring, maintenance, and likely one or more surgical procedures to remove or replace the devices over their lifetime. This necessity for future intervention is a fundamental part of having breast implants.
Understanding the Expected Lifespan
Breast implants, whether saline or silicone gel, have a general expected lifespan but are not permanent. Most implants are estimated to last between 10 and 20 years, though many individuals require removal or replacement sooner due to complications. Longevity is influenced by the implant type, surgical technique, and the patient’s individual body response.
The material affects durability and how quickly a problem becomes noticeable. Saline implants deflate visibly and quickly if a rupture occurs, as the body harmlessly absorbs the sterile solution. Silicone implants, filled with cohesive gel, often remain contained within the scar tissue capsule even if the shell ruptures.
This containment means a silicone rupture can be “silent,” lacking obvious signs or symptoms, making its true lifespan difficult to gauge without medical imaging. The body’s natural formation of a scar tissue capsule around the implant contributes to the need for eventual intervention and complications.
Types of Implant Failure and Detection
Implants require surgical intervention due to mechanical failure of the device or complications involving surrounding tissue. A mechanical rupture in a saline implant is typically symptomatic, resulting in rapid breast deflation that is immediately noticeable to the patient. Although the sterile saline is safely absorbed by the body, the empty shell must still be surgically removed.
Silicone gel implants often experience a silent rupture where the tear does not lead to immediate change in breast shape or size, as the cohesive gel remains contained. This type of failure requires proactive detection through specialized imaging. If the gel leaks beyond the scar tissue capsule, it is termed an extracapsular rupture and may cause symptoms such as lumps, pain, or changes in breast contour.
A primary biological reason for explantation is capsular contracture, which occurs when the natural scar tissue capsule around the implant tightens and squeezes the device. This complication can appear months or years after surgery. Symptoms include increasing firmness, tightness, pain, or a visible distortion in the breast’s shape, often making the breast feel hard or ball-like.
Required Long-Term Monitoring Commitments
Because implants are not permanent and complications can be silent, long-term medical surveillance is a necessary commitment. Regular clinical examinations by a physician are important to check for subtle changes in firmness or contour. Patients should also perform regular self-examinations to monitor for pain, swelling, or changes in breast symmetry.
For individuals with silicone implants, the U.S. Food and Drug Administration (FDA) recommends periodic imaging to screen for asymptomatic rupture, starting five to six years after surgery and then every two to three years thereafter. Magnetic Resonance Imaging (MRI) is the most effective detection method. An ultrasound may be an acceptable alternative for screening asymptomatic patients, but MRI is recommended if symptoms appear or ultrasound results are inconclusive. Patients must also inform their radiologist before a mammogram, as the presence of the device can obscure breast tissue and may necessitate specialized views.
Options for Explantation and Replacement
When an implant reaches the end of its useful life or a complication arises, surgical intervention is required. Patients and surgeons have two primary options: explantation with replacement (implant exchange) or explantation only. Replacement involves removing the old implant and immediately inserting a new one.
Revision surgery is often more complex than the original augmentation, especially if capsular contracture is present. In these cases, the surgeon may perform a capsulectomy, which is the surgical removal of the surrounding scar tissue capsule.
Types of Capsulectomy
A capsulectomy can be performed in several ways:
- A total capsulectomy removes the entire capsule.
- An en bloc capsulectomy removes the implant and capsule together as a single unit, often preferred when a rupture has occurred.
Some individuals choose explantation only, removing the implant without inserting a new device. Since the skin and breast tissue may have stretched, this removal may be combined with a breast lift (mastopexy) to reshape the tissue and remove excess skin. Any new implant inserted will also have a limited lifespan and require the same long-term monitoring.