Replace Your 2nd Generation Breast Implants!

Stop putting it off, make it your New Year’s resolution… If you (or someones you know) have breast implants from the early 90’s, 80’s, or (yikes!) the 70’s, you need to get them replaced. It seems like lately I have had a run of patients with those old second generation implants, and each patient has had one or both of their implants ruptured when I’ve gone in to replace them. No surprise to me, but the patients sometimes seems shocked. One patient mentioned that an MRI done a year ago showed a rupture but the radiologist indicated it wasn’t a big deal, and surgery to have it replaced was probably not worth it. No referral to a plastic surgeon was suggested. Really?! I might have thought that it was the patient’s misinterpretation of the radiologist’s assessment, but sadly, it’s not the first time I’ve heard that story.

Unlike today’s implants, the gel from those old implants is a goo, and if it leaks beyond the breast capsule, can cause problems such as silicone granulomas or axillary lymphadenopathy. So any known rupture of an implant, even an “intracapsular” rupture where the gel hasn’t yet leaked outside of the capsule, needs removal or replacement, no matter what any other physician might say. The fact that an implant of that generation has a high likelihood of present or imminent rupture should prompt removal and replacement. No need for MRI at this point (unless for other reasons) – just get them out!

Compared to the televisions, computers, or cell phones you’ve replaced over the last 20 years, breast implants might not seem too complex. But the implants we use today are 4th or 5th generation implants. These are round or shaped implants containing precisely engineered silicone gels that are married to the implant shell in a way that those old implants weren’t. They’re not a “goo” so they can’t really “leak” the way the old silicone did. Nevertheless, even for these implants there is a suggested protocol for follow-up with periodic MRIs (high resolution ultrasound probably just as good). Even for today’s advanced implants, I tell patients to be proactive. Follow the MRI guidelines and consider changing implants between 10-15 years.

Dr. Douglas Mackenzie
Santa Barbara, CA

Douglas J. Mackenzie, MD

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