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Breast augmentation is an operation that works exclusively because of the implant. Like joint replacement surgery, the operation is completely dependent on a medical device for its result. Like all medical devices, breast implants will eventually fail for some patients at some point in their lives. Because of this concern, I not infrequently hear questions from breast augmentation patients asking….is it time for me to replace my breast implants?

As a general statement, you do not need to replace breast implants until they develop a problem, known as failure. They is no known benefit to replacing them just because they are ‘old after ten years, for example, or some other length of time. You replace them when the device fails.

The presentation of failure will differ depending upon what type of breast implant is used. Saline implant failure is usually quite obvious as it develops a leak and the breast size begins to change. In other words, you develop a ‘flat tire’. Whether the leak is slow or fast, your breast gradually gets smaller. This is tantamount to a cosmetic emergency and there will be no question as to whether it needs to be done. Silicone gel implants, however, fail differently. Because the gel is not a liquid, it will not come running out and cause a dramatic change in breast size. Rather silicone gel implant failure may not be obvious at all as the breast will not change size. Its failure is ‘silent’ and often will only be picked up by mammogram or MRI. If the breast looks good and is pain-free, one can have the debate if it should be replaced at all since it will cause no harm to your body (because of the tear) and the breast size has not changed. Certainly there is no urgency to replace it like in saline implants. One has a lot of time to decide if replacing it needs to be done now or later.

Dr. Barry Eppley

Indianapolis, Indiana

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