Reply To: Breast Augmentation By Implant for Beginners

[Michelle Lawson]

<u>Longevity:</u>

Breast implants do not have an expiration date; nor do they have a ‘best if used by’ date. But they probably will not last a lifetime. Obviously the ‘lifetime’ part will depend on how old you are when you get them. I have heard of a woman that got implants who was in her 70s. Less than 20% of women with implants will have them removed or replaced in the first 8 to 10 years. Eric Culbertson, MD on the The American Society of Plastic Surgeons website states breast implants “to last more than a decade, with the chance of rupture increasing about one percent each year. That means after a decade, there is a 90 percent chance that the implant will still be fully intact.”

And what about longevity as it relates to the implant type, saline or silicone, texture, or fill? From one website:

Saline breast implants will last longer if they are at their maximum fill amount as recommended by the manufacturer. Underfilled saline shells may fold and wrinkle before meeting their potential fate: a rupture. Continuously folding the implant shell creates friction and friction often equates to failure, explicitly causing the implant(s) to deflate over time as the saline solution leaks out. Underfilled saline implants have one of the highest rates of failure. The rupture rate for saline in a 2014 study was 5.6 years. Of the 48 ruptured saline implants studied, 26 implants were underfilled.

Just as an implant can fail due to underfilling, it can fail if overfilled. Manufacturers suggest overfilling a saline implant no more than 10-15% of the maximum fill amount to maintain shell integrity. Overfilling is filling above the maximum fill amount. Some surgeons have been able to expand the saline implant shell 20% more than the manufacturer recommends. While that may give some patients the look they are after, going more than 15% over can result in implant failure in the future.

The saline implants that have a textured shell and reach the manufacturer’s recommended maximum fill have the highest chance of survival. In the same 2014 study, surgeons found that of the 45 ruptured saline implants, only 16 were textured implants.

With silicone implants, surgeons are unable to add silicone to the implant to give the patient the benefits of the correctly filled saline implant. However, silicone implants have a vast advantage over saline implants in that the silicone gel acts as a solid instead of a fluid. If a silicone implant were to rupture, the gel will remain intact and is more likely to retain its form. Being form-stable and having the ability to remain contained, means silicone implants will have a longer life. In the same 2014 study, the mean duration of implantation until rupture was 12 years. In the 49 silicone implant failure cases studied, 11 implants were textured shells and only four were smooth.

In fact, one company has developed a silicone implant that may outlive traditional silicone implants–Allergan has introduced the Inspira line. Inspira implants have been available in Canada for some time, and now they are available to U.S. patients. The Inspiras have a slightly overfilled shell, preventing the implant from folding inside the breast.

Breast implants could last a short time, or many decades, depending on what you choose as the implant, how your body reacts to the implants, and your lifestyle. This is definitely a topic worth serious discussion with your surgeon.