Breast implants eventually need to be replaced or removed. Replacement is usually a simple procedure, but the trick is to know when you should do it. Removal without replacement is addressed in our breast implant removal page.
Many patients ask us when they should replace old implants. The truth is, problem-free implants do not really need to be replaced. If your implant is saline, and if the size of the breast is normal, then the implant is intact. As the implant gets older, the chance of rupture gets higher, so it's good to put a plan in place in case the implant ruptures unexpectedly. If the saline implant does rupture, it releases the saline fill into the body. The saline is a common sterile IV solution used for rehydration, so it is not a cause for concern. If your implants are twenty years old and still intact, come in for a consultation to discuss a replacement plan. Think first if you want to increase the size, decrease the size, or consider complete removal.
There are actually fifty or more different types of silicone breast implants, all filled with different types of silicone, that have been approved by the FDA over the years, many of them since recalled1. All silicone implants over twenty years old should be replaced, as they are at high risk for rupture. While ruptured implants can sometimes sit harmlessly in the capsule, the silicone of an older, gel-type implant will become incorporated into the capsule when ruptured (intracapsular rupture), and can travel outside of thje capsule and into the lymph nodes2 (extracapsular rupture). Newer implants should also be replaced if they are ruptured, or if the implant style has been recalled. Textured implants, specifically the Allergan 410 implant, carry a tiny but real risk of Breast-Implant-related ALCL (BIA-ALCL) and should also be replaced sooner than later. The capsule should be checked and possibly removed at the same time.
1U.S Food & Drug Administration. The FDA Requests Allergan Voluntarily Recall Natrelle BIOCELL Textured Breast Implants and Tissue Expanders from the Market to Protect Patients: FDA Safety Communication. Available:
https://www.fda.gov/medical-devices/safety-communications/fda-requests-allergan-voluntarily-recall-natrelle-biocell-textured-breast-implants-and-tissue. Accessed February 15, 2021
2Mayo Clinic. If silicone breast implants rupture, what are the possible complications? Available:
https://www.mayoclinic.org/healthy-lifestyle/womens-health/expert-answers/breast-implants/faq-20058454. Accessed February 15, 2021
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