Here’s What You Need To Know About Replacing Breast Implants
While breast implants come with a lifetime warranty on the implant device, they are not actually meant to last a lifetime. It is recommended that both silicone breast implants and saline breast implants be replaced every 10 years or so, but that is not the only reason women opt to swap them out. The natural aging process, pregnancy, and weight fluctuations can all affect the size and projection of the breasts, and replacing implants may be able to address these changes in appearance. So, what does a breast implant replacement procedure entail? The AEDITION breaks it down.
Why You Need To Replace Breast Implants
Generally speaking, it is recommended that patients replace their implants every 10 years. That wisdom is largely based on a 2011 report from the Food and Drug Administration (FDA) about the safety of silicone breast implants. It found that the longer someone has them, the more likely they are to experience localized complications (think: deflation or rupture).
In the study, 20 percent of women with silicone gel-filled breast implants required removal or replacement within 10 years of implantation. For patients who do not experience issues with their implants, surgeons may advise that it is not necessary to change them. “The newest implants are the fifth-generation silicone implants,” says Melissa Doft, MD, a double board certified plastic and reconstructive surgeon in New York City. “They are much sturdier than earlier generations — meaning the shell does not break down as quickly and they are less likely to leak.”
But that doesn’t mean breast implant replacements aren’t common. “The implants are constantly improving, so the implants today will be inferior to the ones in 20 years,” Dr. Doft explains. “Many patients elect to upgrade.” In addition to receiving a more high-tech implant, the procedure allows patients to revise or refine the results of a previous procedure.
The Longevity of Silicone vs. Saline Breast Implants
Saline implants have a similar longevity (i.e. a decade) to their silicone counterparts, though there is a key distinction. “The biggest difference between the two is how they are monitored,” Dr. Doft says. As she explains it, when a silicone implant ruptures, it is considered a ‘silent rupture’ because the gel tends to be contained in the scar tissue capsule the body forms around the implant. As a result, the rupture is only detectable via imaging, like an ultrasound or MRI.
On the contrary, if a saline implant ruptures, the salt water is absorbed by the body and there is an observable loss of fullness in the breast. “The rate of deflation of a saline implant is one percent per year,” she explains. “The rate of rupture for the fifth generation implants by Sientra and Allergan is about nine percent over 10 years.”
For implant patients who are concerned about potential complications, Dr. Doft says size matters. “Using the smallest implant that will achieve your goals is the best precautionary measurement,” she shares. “It is well known that smaller implants have significantly less complications.”
Breast Implant Replacement Surgery
The breast implant replacement procedure is similar to the initial breast implant surgery. “If you have decided to change your implant because you have had them for a long time, you want to switch from saline to silicone, or they are textured and you are worried about developing ALCL but you have no visual changes, it is easy to replace them and you should have a very similar result,” Dr. Doft explains. “The goal of the surgery is to have a beautiful soft result and usually this can be achieved.”
It should be noted, however, that there may be challenges that were not present during the original breast augmentation. An abundance of scar tissue, for example, may make the revision surgery more complex. “If you are replacing the implant because of capsular contracture — scarring around the implant which has caused a visual change or made the implants painful — changing them is a longer operation and more tricky,” Dr. Doft says.
Choosing New Implants
When considering a breast implant revision or replacement, patients should first consult with a board certified plastic surgeon to evaluate the current situation. During the consultation, the surgeon will get to know the patient’s aesthetic goals and help determine the best type (silicone gel versus saline), shape, and size of implant for the revision.
“When patients wish to change their implants, they often consider changing the size of the implant,” Dr. Doft says. She has noticed a change in aesthetic trends over the years, with the preference for larger implants in the 1990s and early 2000s moving toward smaller ones in recent years. “Patients often had larger implants placed when they were younger and, now that they have aged, find that the larger implant feels heavy and can make them look too busty or too bulky,” she says. “These patients also tend to elect to have smaller implants.”
For women who are exchanging their implants after pregnancy due to deflation or ptosis (read: sagging), however, a larger implant may be preferred. “Sometimes, by placing a slightly larger implant, the sagging can be removed,” she says. “In a nutshell, I think older patients often decrease the size or stay the same size, and younger patients and postpartum patients stay the same or increase in volume.”
Procedures to Pair with a Breast Implant Replacement
While a larger breast implant may be able to correct postpartum breast changes in some patients, it is not always enough. “If their breasts have changed from weight loss or pregnancy, often women will have a breast lift at the same time,” Dr. Doft shares. But that’s not all. “Many times, patients will also have a separate procedure — like liposuction, abdominoplasty, or blepharoplasty — to optimize their downtime,” she adds.
Recovering From a Breast Implant Replacement
While recovery depends on the patient and specifics of the procedure, many women find the healing process less painful than their original surgery. “Many American surgeons place the implant under the pectoralis muscle when performing the initial operation,” Dr. Doft explains. “The surgeon creates a new space that had not existed and the implant applies pressure on pectoralis muscle causing postoperative pain.”
In the replacement procedure, that space does not need to be recreated. “The pocket has already been created, so there is significantly less pain after the surgery,” she says. “Most patients return to work in a few days.”
Whether you’ve had your implants for more than a decade or are looking to reverse the effects of aging, pregnancy, or weight changes, breast implant replacement procedures allow patients to refine the results of previous breast surgeries. In addition to changing the size and shape of the chest, the procedure can be coupled with additional cosmetic surgery procedures (think: breast lift, liposuction, abdominoplasty) to maximize the downtime and results.