I have been asked this question ever since I started in practice and my answer has never varied. It is not unusual for patients to consult with me and ask me if they need to have their implants changed at regular intervals. Usually a time of ten years is cited but I have heard every eight years and even as often as every five years. Until recently I did not know why this was such a common question but I now know there are surgeons practicing even within my community who tell patients they need to have them changed at routine intervals. I am far from alone in believing this is utterly false and misleading. A quick search for answers on this question reveals many surgeons blogs and commentary, all of which is generally in agreement with my views.
What are the chance of breast implants leaking?
I believe the chances of implant leakage is very low for many years, only rises gradually over time, and that operating on otherwise well patients without a reason when they have an other wise satisfactory result, exposes them to risk, and expenses which are entirely unnecessary. The only benefits are to the plastic surgeon. There is no scientific literature to support regular implant exchange, nor does the manufacturers’ product literature suggest this.
Not even breast implants last forever
This is in spite of the fact we never suggest implants will last a “lifetime”. The risk of leakage in the first ten years is very low probably less than 5%, and only rises gradually over time. A leak in a saline implant results in saline being quickly absorbed; the body is 70% composed to begin with, and the resulting loss of volume( size) makes a leak obvious, without any special tests.
Leaking silicone implants are no longer even suspected of causing diseases as they were accused in the late 1980′s and early 1990s. But the diagnosis of a leaked silicone implant is more difficult to make than saline. Generally there will be little or no external sign of a leak, and it is for this reason in the USA the FDA requires all patients with silicone containing implants to undergo regular MRI exams to screen for leakage ( mammograms and breast ultrasound are of limited value in screenings for leaks). However Canada, like Britain, France, Germany, Australia, New Zealand and other countries with similarly advanced medical systems like ours, do not feel this kind of screening for leaks is needed. I generally suggest an MRI be considered at about 8 – 10 years after surgery although in the future advances in technology will likely make some other less costly technique satisfactory. There is some support at this time for the use of “high definition ultrasound” which would be much less expensive and easier to use than MRI exams, but currently, an MRI is still the standard for diagnosis of leaks with silicone gel filled implants.
If the implants are intact…leave them alone. Unless you have another good reason for surgery.