Silicone breast implants are a common choice for breast augmentation or reconstruction. While these devices can provide lasting aesthetic and personal satisfaction, they are not intended to be lifetime implants and often require replacement. Understanding why and when replacement might be necessary helps individuals make informed decisions about their breast health.
The Typical Lifespan of Silicone Implants
Silicone breast implants are not designed to last indefinitely, with longevity varying significantly. On average, implants last 10 to 20 years before replacement. A meta-analysis estimated the median lifespan of a silicone gel implant at 16.4 years, with 79.1% intact at 10 years and 48.7% at 15 years. Regular monitoring is recommended for silent ruptures, as the risk increases after the first decade. While technology has improved durability, factors like body changes, implant placement, and external trauma influence viability.
Common Reasons for Replacement
Implant replacement may be necessary due to medical complications or evolving patient preferences.
One medical reason is implant rupture, where the shell breaks. Silicone implants often experience “silent ruptures,” meaning the shell tears but the gel remains contained within the scar capsule, often without symptoms. This type of rupture is a reason for routine imaging surveillance, as it may not present with immediate visible signs like a saline implant rupture.
Another common medical reason is capsular contracture, where the scar tissue capsule around the implant hardens and tightens. This can lead to pain, breast distortion, and firmness, with severity ranging from mild to disfigured breasts classified by Baker grades. Other medical issues include rare infection, or implant malposition/displacement affecting breast appearance.
Beyond medical necessity, individuals may choose replacement for aesthetic reasons. This can include desiring a different size or shape, visible rippling or wrinkling, or natural breast tissue changes like sagging (ptosis) that prompt revision for a more youthful contour.
Recognizing Signs of Implant Issues
Identifying potential issues with silicone implants involves recognizing various physical signs. Localized discomfort or persistent pain in the breast can signal an implant problem, potentially indicating capsular contracture, a leak, or nerve impingement.
Changes in breast shape or size, such as distortion, asymmetry, or altered contour, may suggest implant shifting or rupture. Lumps or areas of hardness around the implant can indicate capsular contracture or leaked silicone gel.
Swelling or redness might point to inflammation or infection. Numbness or altered sensation around the breast or nipple can also be a sign. When implant edges become visible or palpable through the skin, this is known as visible rippling or wrinkling. Any of these signs warrant consultation with a plastic surgeon for diagnosis and guidance.
What to Expect During Implant Replacement
When implant replacement is necessary, the process typically begins with a thorough consultation with a plastic surgeon. During this discussion, the surgeon evaluates the current implant condition, discusses the reasons for replacement, and outlines available options, which may include removing existing implants and inserting new ones.
The surgical procedure usually involves removing the old implants; in cases of capsular contracture or rupture, the surrounding scar capsule may also be removed. New implants can then be placed during the same surgery, with the approach tailored to the specific reason for replacement and the individual’s anatomy. General anesthesia is typically used.
Recovery periods vary, but many individuals can return to normal activities within one to two weeks, though strenuous activities and heavy lifting are usually restricted for about a month. Soreness, swelling, and bruising are common during the initial healing phase, and following the surgeon’s post-operative instructions, including wearing a surgical bra, is important for optimal results.