The short answer is if it is not broken, don't fix it. Or put simply - if there is nothing wrong with them and if you are still comfortable with them, there is no need to have them removed or replaced.
Many things can happen to Breast Implants during your lifetime whether you had them placed for cosmetic or reconstructive reasons. The latest statistics showed that around 35-45% of patients with breast implants in place require some form of revision procedure within 10-15 years of their initial implant surgery.
The most common reason for revisions is actually patients' desire to change implant size. This can be due to a simple change of mind in regards to the patients' self-image or suitability for their lifestyle; or it can also be due to changes in the natural breast size, secondary to weight fluctuations, pregnancies, and other hormonal changes.
Other reasons for implant revisions include movement of the implant, such as migration upwards or outwards resulting in asymmetry between the two sides. Sometimes it is the natural breast tissue that has shifted, resulting in the implant sitting relatively higher compared to progressively 'sagging' breast tissue (most commonly occurs after breast feeding or menopause). This can give your breasts an odd shape which can be difficult to hide without a supportive bra. In the latter scenario, the implants may not need to be revised, but rather, a beast lift may be required to reposition the breast tissue over the implant.
Implant revision for implant rupture is not as common nowadays. If you had implants put in during the 1980's and 90's then you may need a revision as the rupture rate of those implants are around 20% at 5 years, which means, by now, there is greater than 80% chance that your implants are ruptured. Some ruptures are not detectable unless an ultrasound or mammogram has been performed. Even then, true intracapsular rupture (rupture contained in the capsule) can only be definitively diagnosed by an MRI. Implants from 2000 onwards are made of cohesive silicone and have a rupture rate of 0.4-0.8% per year. Thus, revision for rupture for these implants are uncommon and usually contained as the silicone within the implant is not liquid.
Finally, implant revisions may also be necessary for capsular contracture a condition where the body forms a hard calcified capsule around the implant. This may or may not be associated with an underlying rupture. Capsular contracture is not as common when the implant is under the muscle. Capsular contracture is diagnosed by clinical examination, where the implant can be felt as a hard shrunken lump behind the breast tissue, similar to that of a cricket ball, and can be associated with significant discomfort.
Our next blog will look at signs and symptoms associated with breast implant problems.
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