Keep Abreast of Your Breast Implant Maintenance – What You Need To Know
Breast augmentation was the second most popular surgical procedure performed in the US last year. 80% of the breast implants used were silicone and 20% were saline. Implants have helped women of all ages enhance their overall look but, like many success stories, we also hear about the horror stories of breast implants gone wrong. For the majority, these implanted devices seem to work just fine. To get better insight on breast implant maintenance, I spoke with board-certified plastic surgeon, Dr. Mark Solomon
Mary Cunningham: Under what circumstances should someone replace her breast implants?
Dr. Solomon: There are several reasons to replace implants. Saline implants should be replaced when they deflate. The diagnosis for this is generally obvious but if you have any questions and/or concerns, you should consult with your plastic surgeon. If saline implants are intact, nothing generally needs to be done. Capsular contracture (when the scar tissue capsule that forms around breast implants shrinks squeezing the implant causing the breasts to harden) can occur with implants and will often require surgery to fix it.
Older silicone implants should be replaced for rupture or hardening. Rupture of a silicone implant may be difficult to detect, so an MRI is recommended to determine the integrity of the shell. A finding known as a "linguine" sign on MRI indicates there is a rupture. Other findings are harder to interpret and require input from your surgeon. He/she will also check for changes in position, shape and feel of the implants. Newer (2006 and later) silicone implants have low rupture and capsular contracture rates, but should be studied by MRI to assess their integrity. FDA recommends patients start getting MRI studies about 3 years after implantation.
MC: If there's nothing pressing or noticeably wrong with them, is it still advised to replace them after a certain number of years?
Dr. Solomon: In my experience, if there are no problems, patients should leave their implants alone. Replacement does not guarantee that the new ones won't create a problem, so, if it works, don't mess with it.
MC: Do different types of implants require replacement more often than others?
Dr. Solomon: I tell patients that saline implants will almost always leak if in place for a long period of time, generally 20-25 years. But if the implant is intact, there is no reason to change it unless there are issues such as rippling or desire for size change.
MC: Do you think enough women are aware of breast implant upkeep?
Dr. Solomon: These devices are fairly low maintenance, but patients should monitor their breasts after surgery by visiting their surgeons. The concept of MRI for monitoring silicone implants is something that I discuss with patients, but very few patients follow through because of the cost of the MRI.
MC: After the first year, how often should a woman see her plastic surgeon to have them checked?
Dr. Solomon: I ask my patients to return once a year forever, but few do. Most women are happy and want to go on with their life. However, women should get annual breast exams, and--when over 45 follow recommended breast cancer screening studies like serial mammography.
MC: What do you wish more women knew about keeping their implants healthy?
Dr. Solomon: Most women tend not to notice if they have gradual hardening of their implants until things are very far along. I have had success using non-surgical means for patients with early hardening; routine follow-up is helpful to monitor that aspect of implants. Bottoming out (when the implant slips down lower on the chest) is another issue that can occur with time. If caught early it is easier to treat, but will require surgery whenever it is seen.
Dr. Solomon, thank you helping us understand what to be on the lookout for. Ladies, keep abreast (ahem) of hardening or slipping of your implants, and don’t forget your annual breast check-ups. Let’s all stay looking good and feeling good!