Breast implants are not lifetime devices. All breast implants will eventually need to be replaced or removed. On average, breast implants last 10-15 years before complications like rupture may occur. Many women have concerns about what happens when their breast implants reach the 20 year mark and beyond.
Do breast implants need to be replaced after 20 years?
Most plastic surgeons recommend replacing breast implants every 10-15 years, even if no obvious complications have occurred. This is to preemptively avoid future problems when the implants are more likely to rupture or leak.
Breast implants are not meant to last forever. The outer silicone shell degrades slowly over time and the risk of rupture increases past the 10 year mark. By 20 years, rupture rates are high enough that proactive replacement is often recommended even if the implants still look and feel normal.
The FDA recommends women with silicone gel breast implants get an MRI screening for silent ruptures starting at year 6-7 and every 2 years after that. About 1 in 4 silicone implants rupture within 13 years, so the risk of undetected rupture is significant by year 20.
What happens if breast implants are left in for 20+ years?
Leaving breast implants in for 20 years or longer increases the risks of the following complications:
- Rupture and deflation
- Capsular contracture (scar tissue squeezing implants)
- Implant leakage and silicone granulomas
- Distortion or displacement of implants
- Wrinkling, rippling, or folds in implant appearance
Rupture rates for silicone gel breast implants are around 15% at 10 years and 30% at 13 years. This means at least 1 in 3 implants will have ruptured by the 20 year mark, if not more. The older the implants, the higher the chance of failure.
Saline breast implants have higher rupture rates than silicone. About 50% of saline implants rupture within 10 years. By 20 years, almost all saline implants would be expected to have ruptured or deflated.
Can I leave my implants in if there are no problems at 20 years?
While it may seem fine to leave aging breast implants in place, it is still recommended to have them proactively replaced around the 10-15 year mark.
Waiting to replace implants until a problem arises can make the surgery more complex and dangerous. Ruptured silicone gel from a broken implant that has been leaking a long time can migrate and cause extensive scarring or inflammation. Enlarged capsules around implants also get thicker and harder to correct the longer they are left in place.
Although breast implants can technically remain functional beyond 20 years in some women, the risks steadily rise with time. Removing and replacing the implants before complications set in is the safest approach.
What are the risks if breast implants are left in for over 20 years?
Potential risks of leaving breast implants in longer than the recommended 10-15 years include:
- Rupture and deflation – Higher likelihood of silicone or saline leaking from shell
- Implant displacement – Shifting or dropping position of implant
- Capsular contracture – Hard, painful scar capsule squeezing implant
- Infection – Bacteria entering through weakened shell
- Silent rupture detection – Undetected leak without obvious symptoms
- Granulomas – Inflammatory nodules from leaked silicone
- Interference with mammograms – Ruptured implants obscure breast imaging
- Implant extrusion – Implant breaks through the skin
- Repeat surgeries – More complicated revision procedures needed
The longer breast implants are left in place, the higher the complication rates. Getting implants proactively replaced before age and wear cause too much degradation can help avoid future problems.
What are the signs breast implants need replacing after 20 years?
Some signs breast implants may need replacement after being in place 20 years or longer include:
- Breast size or shape change
- Rippling, ridges, or wrinkling of breast tissue
- One breast feels firmer or appears larger than the other
- Sagging or bottoming out of breast position
- Pain, tenderness, or swelling in the breasts
- Numbness or burning in the breast or nipple
- Fluid collecting around the breast (seroma)
- Thick, noticeable scarring around the implant
An MRI is the best way to screen for silent rupture of silicone gel implants. Saline implant ruptures are more obvious as the breast deflates quickly when the shell fails.
What happens if ruptured breast implants are not replaced?
If a ruptured breast implant is not replaced, the possible consequences include:
- Deflation – Loss of breast volume and shape
- Scar tissue contracture – Hardened, painful breasts
- Silicone migration – Leakage and granuloma formation
- Infection – Bacteria entering the implant pocket
- Asymmetry – Uneven breast size and appearance
- Interference with mammogram – Difficulty detecting cancer
- Additional surgeries – More complicated revision procedures
Once an implant rupture has been detected, it is advisable to have the implant removed and replaced. Leaving a ruptured implant in place raises the likelihood of problems like capsular contracture and silicone migration. The defective implant should be replaced as soon as possible.
Can ruptured breast implants be left in place safely?
It is not recommended to leave a ruptured breast implant in place long term. Some key reasons why ruptured implants require replacement include:
- Silicone gel bleed – Can migrate to lymph nodes or other tissues
- Infection risk – Bacteria entering compromised implant shell
- Capsule contraction – Hardened scar tissue around implant
- Asymmetry and visible distortion – Changes breast shape and feel
- Mammogram difficulties – Ruptured implant obscures imaging
- Additional surgery – Replacing later is more complicated
While a small tear may not cause immediate issues, larger ruptures and long term damaged implants need to be removed and replaced for safety.
How urgent is it to replace ruptured breast implants?
Replacing ruptured breast implants is recommended as soon as reasonably possible for optimal safety and results. However, as long as no acute symptoms are present, it is not an emergency situation requiring immediate surgery.
Planning the surgery a few weeks or months out allows time to research surgeons, get consults, and schedule the procedure for maximum convenience. But the replacement should not be delayed excessively long term.
In uncomplicated cases, getting the surgery done within 6 months is reasonable. Severe contracture, infection, extensive silicone leakage, or other concerning factors may warrant more prompt action.
Discuss your specific case with a board certified plastic surgeon to determine the ideal timeline for your replacement surgery based on the degree of implant rupture.
How are ruptured breast implants replaced?
The basic process to replace ruptured breast implants involves:
- Existing implant removal – The old implant is taken out through the original incision.
- Capsule removal or modification – Scar tissue capsule is excised or surgically modified.
- Infection treatment – Any infection is cleared with antibiotics or drains.
- New implant placement – A new implant is inserted into the implant pocket.
- Incision closure – The surgical cut is sutured closed.
The same incision around the areola, under the breast, or in the armpit can typically be reused to access the implants. But if there is severe scarring or capsule contracture, a different incision site may be needed.
Adjustments are made to the implant pocket as needed, and antibiotics help prevent infection. Drain tubes may temporarily be placed to manage fluid buildup after surgery.
Does breast implant insurance help cover replacement costs?
Unfortunately, health insurance and warranty coverage is very limited when it comes to breast implant replacement costs. Possible options include:
- Manufacturer warranty – Covers ruptured silicone implants for 10 years
- Insurance claims – If capsular contracture is causing pain/deformity
- Healthcare sharing – Partial reimbursement possible from some networks
- Cosmetic surgery financing – Payment plans and loans available
- Self pay – Most women pay out of pocket for implant replacement
Make sure to get all the facts on what manufacturers and insurers will cover before assuming replacement costs will be paid. Having a financial plan for the procedure is important.
How much does it cost to replace implants after 20 years?
The average cost to replace breast implants after 20 years ranges between $5,000 – $10,000 depending on several factors:
- Surgeon fees
- Anesthesia fees
- Hospital or surgical facility costs
- Cost of new implant devices
- Extent of capsule removal or modification
- Other surgical factors unique to case
Simple implant replacement may start around $5,000, while complex revision surgery could cost $10,000 or more. Many plastic surgeons offer patient financing plans to make costs more affordable.
Can I downgrade implant size when I replace them?
Yes, it is very common for women to opt for smaller breast implants when having their implants replaced after 10-20 years. There are a few reasons for downsizing:
- Gravity and aging changes breast shape and lift over time
- Large implants carry higher risk of complications
- Patients often prefer a more modest, proportional look later in life
- Revisions usually require tighter implants to offset natural sagging
Be sure to communicate your desired size to your plastic surgeon. It is perfectly fine to go smaller or larger with your replacement implants.
What are Gummy Bear implants?
Gummy bear breast implants are a type of cohesive gel implant shaped like a teardrop. They get their nickname from their thick, gummy-like silicone filling.
Key traits of gummy bear implants include:
- Thicker silicone gel filling
- Anatomically shaped teardrop form
- Textured surface to reduce movement
- Holds shape better upright and when compressed
- Less risk of silicone gel bleed when ruptured
- May be less likely to wrinkle or ripple
- Often used for revision surgeries
Gummy bear implants are one of the safest options for replacing old breast implants due to their cohesive filling and ability to maintain the desired breast shape. They are FDA approved for breast augmentation and reconstruction procedures.
Should I consider gummy bear implants for replacing ruptured implants?
Gummy bear breast implants are a top choice for replacing ruptured implants after 20+ years due to benefits like:
- Holds shape better over time
- Lower risk of complications
- Minimal risk of silicone leakage
- Ideal for correcting implant displacement or distortion
- Good option for shrinking size from old implants
- Can improve wrinkling and rippling
Their cohesive gel filling and textured surface make gummy bear implants less likely to experience problems like wrinkling, folding, and rupture. Discuss gummy bear implants as an option with your revision breast augmentation plastic surgeon.
Gummy Bear Implant Pros and Cons
Pros | Cons |
---|---|
– Holds shape better | – Limited size options |
– Less risk of leaking | – May feel firmer |
– textured to prevent rotation | – Texturing has controversy |
– Good for correcting issues | – Typically costs more |
– Less prone to wrinkling | – Rarely used for first augmentations |
What questions should I ask my surgeon about breast implant replacement?
Important questions to ask your plastic surgeon about replacing breast implants after 20 years include:
- Should I replace my implants proactively even if no problems are apparent?
- What signs or symptoms would indicate my implants need replacement?
- How urgent is it to replace the implants once a rupture is detected?
- Will you need to modify the implant pocket or capsule during replacement?
- What is the estimated total cost for the replacement procedure?
- Are gummy bear implants a good option for replacing my implants?
- Is now a good time to adjust my breast size if I want to?
- What is the recovery process like after breast implant replacement surgery?
Clear communication with your surgeon is key for ideal results from your breast implant replacement procedure after 20 years.
Conclusion
After being in place for 20 years or more, breast implants have likely reached the end of their normal usable lifespan. Getting aging implants proactively replaced, even without obvious rupture or deflation, helps ensure optimal breast health and appearance going forward. Modern implants like gummy bear varieties provide excellent options for breast enhancement using safer, more durable device technology.