The popularity of breast augmentation continues to grow. In 2008, over 300,000 women had breast implants placed. Another 80,000 had breast reconstruction, of which at least half of these involved the placement of implants. Like all medical devices, they rarely are permanent or last forever. In 2008, nearly 40,000 implants were replaced or removed.
With such significant numbers of breast implants entering and exiting, it is not surprising that numerous misconceptions exist about how long they will last. In fact, many patients say that they have heard that they have to be replaced every 10 years or so. Conversely some patients, usually those who are in need of replacement, express that they were under the impression that the implants would last a lifetime.
The facts are that some breast implants will last a lifetime but most will eventually ‘fail’. Breast augmentation for some could be a single surgery in one’s lifetime, but most patients will eventually need another surgery to replace a deflated or ruptured implant. In my Indianapolis plastic surgery practice, I tell patients that a breast implant will likely have a lifespan shorter than their own. Whether that will be one year, ten years, or twenty-five years is not predictable. The younger you are when you have the surgery, the more likely they will need to be replaced.
Because they are two different types of breast implants, saline and silicone, they do have different lifespans. While the outer shell (bag) between the two is the same, the filling material is different. The action of the filling material and the outer shell accounts for why and how they may fail.
Saline (essentially water) does not buffer the folding and bending of the outer plastic shell very well, exposing it to earlier fatigue and fracture. This results in a clearly discernible external sign of implant failure…deflation. The breast will go down in size rather promptly. Some saline implants do deflate slowly but either way the external breast size goes down. Therefore, 100% of saline implant failures can be seen.
Silicone is a gel (more like jello) which protects the outer shell better, resulting in fewer failures. Failure in a silicone breast implant is known as rupture. But because the gel does not come gushing out like a liquid, the implant does not go down in size. The gel will essentially stay inside the shell. One may have a ruptured silicone implant for years and not know it. Mammograms are not a good way to detect it and only an MRI can provide an accurate rupture diagnosis.
Because of these differences in failure, silicone breast implants do last longer. Scientific evidence does not yet support that belief. But that is only because the current version of silicone implants have not been around long enough for long-term study. (greater than 10 years) But it is a belief that is held by most plastic surgeons today based on what they have seen in their own patients.
Because breast implants are not designed to be permanent and failure is known to occur, each patient should be well aware of the manufacturer’s warranties on these devices. While they don’t change the likelihood of implant failure, these warranties do provide lifetime device replacement and timelines of financial compensation. Their very existence should certainly tell patients that breast implants are well known to fail and and many will need eventual replacement.
Dr. Barry Eppley
Indianapolis, Indiana