Breast Implant Exchange - Part 1

What ultimately happens to the breast implants that we implant?  Some patients don’t really consider that question, or think that once the implants are put in, they are there for life.  Not so.  When I tell patients that their chance of having additional surgery on their breasts is essentially 100%, they are often surprised.  Breast implants don’t last forever.  Sure, I’ve seen implants in for 20 or 30 years without any problems.  I operated on a woman recently who had hard capsular contractures for years and finally decided to have them corrected, along with changing out of her 40+ year old implants.  To my surprise, her silicone implants were both intact, in good condition, but inside extremely hard capsules.  However, this is very unusual. 

I usually tell patients to consider exchanging their implants 10-15 years in the future.  This isn’t absolutely necessary, but with a yearly failure rate of around 1-2% for most implants, there comes a time for most people where the odds of failure are high enough that they would rather be proactive and exchange the implants.  This is a more controlled situation than waiting for something to happen, and then being in a rush to fix it, when schedules and financial considerations may not be ideal. 

Of course, there are other reasons why someone may elect to have their implants exchanged.  Some women decide to go bigger (or rarely, smaller), or change from saline to silicone for a better feel.  Since the FDA re-approved silicone implants for the general market in 2006, many women have come in wanting to exchange their old saline implants for silicone.  Body changes from pregnancies, breast feeding, weight gain or loss, aging, and menopause may also prompt a woman to decide to change her implants. 

In Part 2, I’ll discuss when problems and complications such as capsular contracture or leakage prompt an unplanned breast implant exchange.

Douglas J. Mackenzie, MD, Pacific Plastic Surgery, Santa Barbara, CA