Though breast implants aren't lifetime devices, that does not mean they can't last for many years to come. Some women have had their implants for 10, 20, 30 years—and even beyond. How did they achieve this? Can you?
What’s in a breast implant shell?
Both saline and silicone implant shells are made of silicone. The shell of the silicone implant is constructed from HTV silicone, or high temperature vulcanizing (the curing process) silicone rubber. This form of silicone has excellent strength due to its reinforcing fibers made from silica, a non-toxic substance used in cosmetics, food, and medications. Saline implant shells are made from RTV-2 silicone, or room temperature vulcanizing silicone rubber.
Even though the two are made from different forms of silicone, saline implants are just as stable as silicone implants as long as specific criteria have been met. The difference between the two is the elasticity. The RTV-2 silicone rubber expands much more than the HTV silicone shell, and that is why it is an excellent choice for saline implants.
Reasons for implant failure and replacement
Think of an implant shell as facial skin. You can often tell how one has lived by the lines. The frown lines are from frowning a lot, the elevens (wrinkles between the eyes) occur from squinting, and the smile lines develop from smiling. You can't prevent them unless you spend your life completely motionless (and emotionless). Same goes for implants.
Many implants move within the scar capsule and, over time, the implant may fold. The repetitive folding movements create friction, regardless of implant filler. The integrity of the shell can become compromised if the implant has folded or if it has wrinkles that are repeating the same motion over and over again. This repetitive motion can eventually lead to a rupture.
Hardening of the breast is another reason you might replace your breast implants. Capsular contracture is when the collagen fibers within the scar capsule that surround the breast implant have constricted, resulting in a hardening of the breast. When the level of capsular contracture has reached the point of needing surgical intervention, typically Baker grade III or IV, the implant may be replaced with a new implant or sterilized and re-implanted into the breast.
Extending the life of your breast implants
The longer you have your breast implants, the more likely complications can occur, which increases the possibility you will need to exchange them in the future. However, you can take preventative measures against breast implant failure, and unless you have a complication, you do not need to replace your breast implants every ten years like some may suggest. Here's how you can extend your breast implants by type:
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.
What it Boils Down To
All said an implant could last three months or 50 years. No one can guarantee the life expectancy of any breast implant. Should you have a breast implant that fails before you’re ready for it to, check your warranty. The cost to you may be minimal as the manufacturer may cover the expense of the failed implant.