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Plastic Surgery Articles

Timing of Replacement of Saline / Silicone Implants

Written by:
Beverly Hills, Board Certified Plastic Surgeon

Replacement silicone implantThere is tremendous controversy over the specific timing of replacement of any breast implant. A true myth on the internet and in the world is that implants must be replaced after 10 years. This is absolutely ludicrous and ridiculous. This has nothing to do with changing oil in a car every 3,000 miles. Implants do not need to be replaced after 10 years unless the patient has specific indications. The following are a few of the more prevalent indications for implant replacement:

  1. Ruptured implant. Saline implant upon rupturing clinically will be obvious and the implant will completely deflate. We see these patients often from around the United States who have more or their surgeon is no longer in practice. These implants should be removed as soon as possible, as by the scar tissue around the implant contracture will increase and cause collapse of the pocket. Ruptured silicone implants can be detected most likely by an MRI if the implant is found to be ruptured. Again, these should be replaced as soon as possible.
  2. Capsular contracture or significant scar tissue contracture, Baker IV. There is controversy as to the etiology of scar tissue encapsulation of a silicone and/or saline implant. Many theories are that there is a micro contamination of staphylococcus aureus or epidermis. With this micro contamination of the pocket, the implant should be replaced in the majority of patients. When performing capsulectomies, this may help to reduce recurrent scar tissue contracture. Again, this is extremely controversial and is certainly up to debate.
  3. Rejection of an implant, silicone or saline. Implants are made of dimethylsiloxane. The shell of the implants and the silicone gelatinous material is dimethylsiloxane. I personally believe rejection of an implant is extraordinarily rare and it is hard to determine whether it is truly a rejection or simply a contaminated implant which requires removal. In any case, if a woman has been shown to have an autoimmune disease such as rheumatoid arthritis or systemic lupus erythematosus and their symptoms do not abate, the rheumatologist or immunologist may decide with the Board Certified Plastic Surgeon that the silicone implants may be removed, which once again, may help the patients to relieve some of their symptoms, although this may be placebo at best.

In conclusion, the timing of replacement of implants is not set by a specific clock nor a specific set time. There is no 10-year rule. Patients do present to my office with the thought "I've had implants for 18 years, I must get them replaced immediately." Well, this again is only the case if the patients are clinically having symptoms of scar tissue, pain or a rupture of the implant via clinical diagnosis, saline or an MRI diagnosis for silicone gel implants.

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