They may need replacement due to aging or wear.
One thing a patient focuses on when having breast augmentation done is usually the near future: the recovery, summer bikini season, and the confidence boost. A person in their twenties rarely thinks about their chest in their forties. However, time is something no surgeon can control. After many years, women who had their breast surgeries in the early 2000s and are now questioning, “Is it still safe to have them? What happens to breast implants after 20 years?” are the ones we hear from the most.
At Lin Europe Clinic, we think it is very important for the patients to know how breast implants are after their use. It was the desire of the medical world that the implants were “lifetime devices,” however, the truth is more complicated. Thousands of women suffer no problems for two decades with their implants, but with each passing year, the chances of wear and tear or change in appearance become higher. Whether you have come to this milestone or it is just a matter of years, it is a good practice to know the aging process of both the implant and the body.
The Lifetime Device Myth
The single most important point to remember is that breast implants were never meant to last for an infinite time. It is a general suspicion of the FDA and other health authorities that an implant can only last between 10 and 20 years. However, this does not imply that they are as perishable as a dairy product; they don’t abruptly “go bad” at midnight on their 20th anniversary.
On the other hand, the data indicate that the probability of re-operation grows by about 1% per year. When the 20-year point is reached, only from a mathematical standpoint, the possibility is quite high that a revision operation may become necessary either due to a mechanical failure of the implant or, more frequently, a wish to change the external look.
Structural Fatigue of Implant: The Gram of Tire
One can picture breast implants as the car’s wheels. No matter how carefully you drive and no matter that you never bump into potholes, the tire rubber after all wears out just because of the time passed. This is called shell fatigue. Two decades you implants have endured, besides several activities, the muscles that you use in your chest as well as the one during hugging, lying down, and gravity.
For 20 years the silicone outer layer may become less and less strong, eventually showing tiny cracks or folds. In the case of an old-fashioned silicone implant, the phenomenon of “gel bleed” is one of the consequences, meaning that microscopic particles of silicone which had been passing through the intact shell and on its surface accumulating might make the tissue scar around it getting thicker. Usually, saline implant deflation starts from an aging valve. While the rupture of the implant is not the only outcome, the risk factor definitely rises as the time passes.
Age of the Body and the Implant Changes: Ptosis and Tissue Thinning
Sometimes the implant after 20 years can be in brand new condition, while the breast is not. In any case, your body will still keep on aging, in spite of the operation. Over the span of 20 years, your skin is less elastic, the collagen production is lower, and the natural breast tissue might even become thinner (atrophy) because of hormonal changes such as pregnancy or menopause.
The breast and the implant do not fit together in most cases. The implant basically remains as it was, but the breast tissue sags or slides off it. This produces a deformity which is called “snoopy nose” or a “double bubble” in which the implant is high and the natural breast tissue droops underneath. Weight of the implant all the time for 20 years could cause breast tissue and skin to thin to such an extent that implant edges might become visible or even palpable (ripple). There are many ladies who post their 20 years of implant surgery dream of a revision not because the device is defective but because actually, they want to do a mastopexy that would take away the sagging and finally allowing the implant to flirt with the nipple.
Calcification and Hard Breast: A Typical Old Implant Problem
Besides, there is also a problem of calcified scar capsule with an old implant. An implant’s capsule or scar tissue surrounds it—a scar tissue capsule is in nature the body’s reaction to a foreign body. With time, this layer gets harder and calcium deposits get trapped inside it.
This is harmless but it can change the feel of the breast. Women with 20 year implants commonly notice that their breasts are firmer and sometimes even a bit crunchy to the touch compared to the time shortly after their operation. When the tightening of the capsule is more severe, it becomes capsular contracture – which might cause the shape of your breast to become distorted and also bring some pain that plays the role of the signal to change the implant.
Regular Monitoring is a Must: Silent Rupture
It is very unlikely for you to know whether your silicone implants of 20 years are intact. The rupture of the silicone implant might be “silent”. The capsule keeps the gel inside even if the shell breaks, so the breast looks and feels normal.
For that reason, regulatory agencies instruct older silicone implant patients to regularly do an MRI or a high-resolution ultrasound besides if they have silicone PIP implants. So, in the case of a silent rupture of a 20-year implant, removal or exchange is strongly advised not only to keep a gel leak or silicone migration from taking place but also to stop it interacting with the tissue around it.
Breast Implant Revision
Isn’t it a good idea to simply be aware of the fact and to consult a doctor before you decide to panic at 20 years mark? Lin Europe Clinic, located in Istanbul, Turkey, highly experienced in breast surgery revision, welcome you to visit, discuss the possibility of changing your implant once considered to be of prime quality to modern-day cohesive gel versions that are less risky and more natural to the touch.
There are a lot of specialists in Istanbul who are good at handling aged capsules and tissue with difficulties caused by older age. If what you want is an implant replacement, an old scar tissue removal (capsulectomy), or to get your breast back to the former state by lifting it, here, we offer you a thorough check-up. Besides removing the old, calcified capsule, we usually make the exchange simultaneously in order to enhance your body’s condition to “start anew”. We invite you to choose Turkey as a destination for this occasion to make sure the coming 20 years are just as confident as the last ones.
Frequently Asked Questions About Aging Implants
After 20 years, the chances of “shell fatigue” are greatly increased, thus rupture or leakage are more likely. Other frequent issues are capsular contracture (scar tissue becomes hard), capsule calcification, and the rippling becoming visible as the natural tissues get thinner over the implant.
Even if the implant usually remains round, the natural breast tissue that covers it sags due to gravity and aging. This often results in a situation where the nipple hangs down below the implant (the “snoopy nose” deformity) or the implant appears to be too high compared to the sagging skin (“double bubble”).
It is physically possible, but medically, it is very rare and risky to have the same devices for 40 years without any problems. The shell’s structural integrity deteriorates with age, so if you keep them for such a long time, you must have very strict annual monitoring done by MRI or ultrasound to make sure they haven’t ruptured silently.
The silicone shell deteriorates as it is rubbed and moved for years, resulting in microscopic cracks or “gel bleed” in older models. On the other hand, valves in saline implants may fail causing deflation, while the body’s scar capsule may thicken or calcify, changing the breast from soft to firm in appearance and touch.
Definitely, today’s “cohesive gel” (gummy bear) implants are much safer than the liquid silicone implants that were used in the early 2000s. They are made in a way that the shape is kept when the shell breaks, which lessens the risk of silicone migration. Besides, they give a natural, form-stable appearance.
Food and Drug Administration. (2020). Breast Implants: Local Complications and Adverse Outcomes.
Gabriel, A., et al. (2015). Outcomes of breast implant removal: A 10-year review. Aesthetic Surgery Journal.
Handel, N., et al. (2006). Long-term safety and efficacy of polyurethane foam-covered breast implants. Aesthetic Surgery Journal.
Spear, S. L., & Baker, J. L. (2011). Classification of capsular contracture after prosthetic breast reconstruction. Plastic and Reconstructive Surgery.
