Breast implants are medical devices often chosen to enhance breast size or restore volume lost due to factors like pregnancy or weight fluctuations. They are not designed to last a lifetime, and both the implants and the body’s response to them can undergo various changes with age. This article explores the potential alterations breast implants may experience.
Expected Changes to the Implants
Breast implants themselves can undergo physical changes over time, impacting both their integrity and appearance. A rupture is a significant alteration, with symptoms varying based on the implant type.
Saline implants, filled with a sterile saltwater solution, deflate noticeably and quickly when a rupture occurs, as the fluid is absorbed by the body. This deflation can lead to a sudden change in breast size or shape.
Silicone implants, which contain a cohesive gel, often experience a “silent rupture.” This means the implant shell tears, but the gel remains largely contained within the fibrous capsule that naturally forms around the implant, making it less obvious or even asymptomatic. Causes for rupture in both types of implants include general wear and tear, trauma, or excessive mechanical pressure, such as during mammograms.
Another common change is wrinkling or rippling, where folds in the implant shell become visible or palpable. This is more common with saline implants due to fluid movement, or when there is insufficient natural breast tissue coverage. Implants can also shift from their original position, a condition known as malposition or displacement. This can result in the implant sitting too high, too low (“bottoming out”), or moving to the side, caused by factors like gravity, tissue laxity, or changes in the implant pocket.
The Body’s Long-Term Response
Beyond physical changes to the implants, the body can exhibit long-term biological reactions to their presence. Capsular contracture is a common complication where the scar tissue capsule that naturally forms around the implant tightens and hardens. This can cause the breast to feel abnormally firm, distorted in shape, and lead to pain or discomfort. The onset can range from months to years after surgery.
A rare but serious immune system cancer linked primarily to textured implants is Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL). It presents as swelling, fluid collection (seroma) around the implant, or a mass. Early detection is important for managing this condition.
Some individuals with breast implants report a collection of systemic symptoms referred to as Breast Implant Illness (BII). These symptoms can include chronic fatigue, joint pain, muscle pain, brain fog, and skin issues. While its precise mechanisms are still under research, BII is a recognized syndrome, and many individuals report improvement in symptoms after implant removal.
Aging with Implants
The natural aging process of breast tissue interacts with the presence of implants, influencing their appearance and position. Breasts naturally sag (ptosis) over time due to gravity, collagen loss, and weight fluctuations. This process continues even with implants, as they do not prevent natural tissue aging.
As natural breast tissue sags, the implant may remain in its original position, leading to a disproportionate appearance or a “double-bubble” deformity where the implant’s lower edge becomes visible. Aging can also lead to thinner skin and less supportive tissue. This thinning can make the implant edges more palpable or visible, especially with less natural breast tissue coverage.
Monitoring and Management
Individuals with breast implants should maintain a proactive approach to monitoring their breast health as they age. Regular self-examinations are an important first step, allowing individuals to become familiar with their breasts’ normal appearance and feel, and to detect any changes in shape, texture, or the presence of lumps. Knowing the normal feel of the implant’s edges and surrounding scar tissue helps differentiate them from new abnormalities.
Routine medical check-ups with a healthcare provider or plastic surgeon are advised for professional assessment of the implants and surrounding tissue. Imaging studies play a role, particularly for silicone implants, to detect silent ruptures. The FDA recommends MRI screenings for silicone implants, starting a few years after surgery and continuing periodically.
When issues arise, or due to personal preference, options for managing aging implants include replacement, removal, or explantation with a breast lift. These procedures can address complications like rupture or capsular contracture, or accommodate changes in aesthetic goals or lifestyle.