5 Most Frequently Asked Breast Implant Questions
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I wanted to share the most frequently asked questions in my dedicated cosmetic and reconstructive breast practices after a decade of experience working with breast implants. Over the past 10 years we have focused on not just primary breast surgery but also taken a special interest in revisional or revision breast implant surgeries as well. This diversified breast surgery portfolio has enabled our team to accumulate a vast experience and knowledge base in regards to common and very uncommon complications and issues related to breast implants.

So let me share with you our top 5 list of questions and issues with Breast Implants

1. Are Breast Implants Everlasting? and Do I need to Exchange them Every 10 Years?

I think the answer is a bit tricky and has been complicated by breast implant manufacturers placing a 10-year expected replacement date on their product. In my opinion, the answer is a NO and you are not obligated to replace complication free implants if you are happy with your results. The idea behind replacing breast implants at a set interval of time is that the risk of implant failure or capsule rupture does increase each year. With the increasing risk of rupture, it is recommended to undergo routine surveillance of the implant and this leads into our next breast implant question.

2. When and Should I get imaging of my Implants?

This is probably one of the most important questions to answer here and in my opinion the answer is yes and at 5 years from insertion. The guidelines from the FDA are now ultrasound or MRI after the first 5 years then every 2-3 years thereafter. The reason why I am pro-breast imaging is for 2 reasons, first it is helpful to know if your implant has ruptured and I have seen cases of early rupture, as early as 3 years after implant insertion, but just as importantly, it is never a downside to have the chance to undergo routine breast imaging. This can not only evaluate the implant integrity but save your life if an early breast finding is noted. Any reason that allows for breast imaging is positive in my mind.

3. Do ruptured Implants need to be removed?

By far the most challenging question of the group and for good reason because as newer generations of implants became more and more cohesive or “stable” and less free flowing the immediate need for removal of a ruptured implant may have decreased. The early generations of implants had lower levels of “cross-linking” or holding arms between the silicone molecuels resulting in a more liquid consistency similar to molasses. With each new generation of implants, now we are at the 5th generation, the consistency of the silicone has firmed up considerably and are often referred to as “gummy bear” implants. The reality is that all silicone implants manufactured today are highly cohesive and should hold form and a diagnosis of rupture does not require immediate intervention if you are not experiencing any additional issues related to the implant, but from my experience, I have seen new generation implants with poor cohesivity when removing them as early as 3 years after insertion. So the answer here is a big maybe and depends on each patients symptoms and implant imaging characteristics as well as using the generation of the implant as a guide.

4. If I Remove my Implants do I need to put Implants Back In to have a Good Breast Shape?

The reasons to remove implants are many and the timing of removal can vary from immediate to 30 years or longer after insertion. The most common reason for implant removal in my practice is that following many years after breast augmentation there is the simple desire to return to the natural self. Patient’s attitude toward body image and breast aesthetic often evolves over time and replacing implants is not desirable. We have developed a technique for implant removal followed by remodeling the breast tissue to achieve a more natural breast shape with our Back to Breast Beautiful procedure. Fat grafting can be employed as a natural option to add breast volume. So the answer is absolutely not!

5. Can my Implants Make me Sick?

Health issues related to implants can be far ranging and has been classified as Breast Implant Illness that includes symptoms of fatigue, mental cloudiness, body and joint aches and at least 30 additional concerning symptoms. For many years researchers have been studying this question and answer has been somewhat elusive. At this point in time, the FDA now considers that there is a possibility of developing a variety of symptoms related to implants. The more important issue to consider is that if you have symptoms will removing implants help you feel better? There is no current test to help us identify patients who will benefit from implant removal but the general consensus is yes. In my experience, most patients will feel an improved sense of wellbeing immediately after removal. Studies have shown that this improvement maybe long lasting although a few patients can feel improvement but then relapse.

I hope our discussion of the top 5 issues in our practice prove helpful and give some insight regarding concerns related to breast implants. This discussion is not meant to be exhaustive of all the questions and problems related to implants but instead highlights some major ones.