How to Tell When Breast Implants Need to Be Replaced

February 8, 2023

Modern materials and surgical techniques have improved the longevity of breast augmentation results, more than ever before – especially when the procedure is performed by an experienced breast surgeon. It is important to understand, however, that even top-quality breast implants are not designed to last forever. While our board-certified plastic surgeon, Joseph DiBello, MD, FACS, advises patients that their implants should be replaced at the first suspicion or sign of a leak (usually occurring after ten years), certain circumstances may call for earlier replacement or even removal.

It may be time to seek breast implant revision surgery if you experience any of the following:

• Dissatisfaction with the feel or appearance of the implants. In most cases, patients simply wish to switch out their implants for a different type or size. For instance, a patient with silicone-filled implants may want to switch to saline-filled, or vice versa. It is also common for patients to want to try a more proportionate implant size or shape.
• A desire to change the implants’ positioning. Particularly if your implants have been in place for a long time, their positioning may be altered due to breast sagging (ptosis). Revision surgery, which can be accompanied by a breast lift (mastopexy), can restore symmetry to the bustline and return the implants to a more flattering position.
• Ruptures or leaks. After time has passed, both saline and silicone implants are liable to leak or rupture. Whereas it’s usually easy to tell when a saline-filled implant has ruptured because the breast(s) may appear deflated as the liquid is absorbed by the body, a silicone-filled implant rupture may be more difficult to detect. As such, the FDA recommends that patients with silicone implants undergo MRIs every 2-3 years.
• Capsular contracture. This condition, while not nearly as common as the reasons listed above, is typically cause for immediate removal or replacement. Manifesting as an abnormal hardening of scar tissue, capsular contracture is recognized by four stages (or “grades”) of severity, with Grade IV often associated with noticeable changes and discomfort.
• ​​Textured surface of current implants. Breast implant-associated large cell lymphoma (BIA-ALCL) is a very rare type of cancer that has been associated with texture surfaced breast implants. Bio Cell textured breast implants were actually recalled at the request of the FDA in 2019. Removing textured implants and replacing them with smooth surfaced implants may be a way to decrease the risk of BIA-ALCL.

Certain other health issues, such as breast implant illness (BII), have been associated with breast implants in the past, but these conditions are exceedingly rare and much research still has yet to be conducted on their relationship to implants.

Furthermore, please note that while most patients experiencing these issues choose to exchange their implants, Dr. DiBello is also able to perform breast implant removal (or “explant surgery”). If you are unsure which procedure is best to meet your medical needs and cosmetic goals, Dr. DiBello would be happy to help you make an informed decision during your consultation. To schedule this initial meeting, please feel free to contact us today.