Posts Tagged breast implant replacement
I read someone said she had to get her implants re-done 20 or so years later. I thought that getting breast implants was a one-time thing. How long do breast implants last?
Breast implant surgery is definitely not to be considered a “one time thing.” That is one good finding that came out of the breast implant craziness of the 1990′s in the US; the time at which the FDA banned silicone gel implants and demanded studies.
Interestingly, the implants themselves are not always the problem that leads to re-operation. It can be the body’s reaction to them. Silicone gel breast implants in particular can encourage a more profound reaction requiring surgery to remove it and soften the breast. Take a look at a piece of a scar capsule that I removed for a woman who had had silicone breast implants about twenty years prior. These things harden the breast quite a bit.
Saline implants do not encourage this kind of reaction (much less so,) but they can break flattening the breast on that side and leading to the need for a replacement operation. With these things being considered, breast implants should probably be considered to have a “lifespan” of ten years on average.
John Di Saia MD
Originally posted 2009-07-06 07:30:24.
Reader Laura’s Comment:
The FDA has announced that the makers of silicone breast implants have not been following up with the women who have received them as requested when they re approved silicone implants. How long can a woman safely have their implants in before they should have them removed or replaced? Is 10 years the norm? Do you have specific time in mind for replacement when the implants are first but in? Do you recommend that your patients get MRIs?
Makers of silicone breast implants have not followed up on thousands of women who received them as required by the Food and Drug Administration as a condition of approval, agency advisers said Wednesday. Mentor Worldwide and Allergan Incorporated received FDA approval for their silicone gel-filled breast implants in 2006 after agreeing to do large, 10-year post-market studies. But in a two-day meeting to update two FDA panels on the status of those trials, the companies admitted they had lost track of large numbers of women after implantation.
Silicone gel breast implants leak small amounts of silicone gel into a patient’s body over the time in which they reside there. There has never been much of an argument there. The real question is whether or not this is well tolerated. The answer is sometimes more than others. It has always left me a bit unsatisfied when implant makers and their spokespeople have stated that silicone breast implants are “safe.” What does that really mean? I recommend silicone breast implants for a small minority of my breast implant patients when their risks seem warranted by benefits. I do not call them “safe” however.
If my wife were to have breast implants she would be having saline-filled models. My opinion is that they are much safer over time.
On the subject of breast implant studies, most patients simply don’t like them. For years we tried to follow our silicone breast implant patients for purposes of follow-up studies. This was back before the FDA made study administration the implant manufacturer’s problem again. The average patient has little interest in coming in for re-evaluation unless there is a problem. Blaming the implant companies for lack of follow-up in this light is not fair.
On the longevity of silicone gel implants, that is an unknown. The newer generation “gummy bear” implants have not been around that long. I think replacement over a ten year cycle is probably conservative, but patients do not always stay with the same surgeon for ten years and that cycle time is not standard.
Breast MRIs are recommended for silicone gel implant patients at intervals but few of these women get them. Breast MRI studies are expensive and health insurance does not cover them usually. In fact, a woman admitting that she has breast implants can get her insurer to refuse to extend policy coverage or rescind it in many cases.
Silicone gel breast implants are controversial and by the looks of things are going to stay that way for the foreseeable future.
John Di Saia MD
In the office we have had a noticeable increase in requests for breast implant removal without replacement. Women are naturally concerned about what things will look like afterward and this does vary quite a bit.
Not everyone needs or wants a breast lift afterward. If the patient’s implants are not too large and are saline-filled, often the operation is quite simple and leaves nice results. On the other hand, old silicone gel implants or their remnants can leave a mess in there. This can require more surgery to repair.
John Di Saia MD