Breast implants: durability and replacement

Implants are not “eternal”. They are devices that age. Around them, the body creates a thin shell of connective tissue (capsule), and over the years the risk of problems increases. Hardness and deformation (capsular contracture), tearing (rupture) or displacement may occur. The decision to replace is not made according to a calendar (“10 years have passed”), but according to the condition of the implant and your symptoms, plus routine checks. This is the most common mistake. The woman waits for the “deadline” instead of monitoring the condition.

How to monitor without panicking: if the implants are silicone, the standard is the first imaging check-up at the 5-6th year after the operation, then every 2-3 years, even if you have no complaints. This is how “silent” ruptures (without obvious signs) are caught. If symptoms appear or the ultrasound is unclear, magnetic resonance imaging (MRI) is required. With saline implants, a routine MRI is not necessary, because when a rupture occurs, the breast visibly “drops”. This schedule is not to scare you, but for peace of mind and early detection.

What is normal to expect over time: the more years pass, the greater the likelihood of rupture or reoperation. This is a cumulative risk, not a defect. In long-term 10-year studies of silicone implants, confirmed ruptures are seen in the range of a few to about ten percent (depending on the model, population and detection method), and the reasons for reoperations are mixed - contracture, displacement, size change, rupture. Regular control is your tool for security.

What signals do you not ignore: a sudden change in the shape or volume of one breast; new firmness, "pulling", pain or pronounced asymmetry; unexpected swelling or a "pocket" of fluid around the implant; a lump in the armpit; a rash/redness over the implant. With such changes, you don't wait, you schedule an examination and imaging diagnostics (usually ultrasound first, if in doubt, MRI). This is the pragmatic path.

Capsular contracture in simple terms: it is a contraction and hardening of the natural capsule, which makes the breast firmer, higher and sometimes painful. Risk factors include microbial contamination and biofilm around the implant, previous contracture, radiation therapy, hematomas and certain surgical features. Therefore, sterile technique in the operating room, the correct size and position of the implant and timely response to the first signs of tightness are important.

About BIA-ALCL - rare, but you should know: this is a lymphoma associated primarily with textured implants. Most often, the first sign is late, unilateral swelling, fluid collection around the implant years after surgery. Diagnosis begins with ultrasound and examination of the fluid. Treatment usually involves removing the implant along with the entire capsule. If you have no symptoms, prophylactic removal just because of the texture is not recommended. It is important to know the signals and react in time.

What to do today if you have implants: if they are silicone and 5+ years have passed - book an appointment for an ultrasound. If in doubt, get an MRI. Collect and keep the "passport" of the implants (brand, model, texture, serial number) - this helps with any future consultation. In case of unilateral swelling, hardness, pain, sudden change in shape or a lump in the armpit - do not postpone an examination. This is not panic, but care and prevention.

The text is informative and does not replace a medical consultation. The most accurate answer for your case comes from a combination: examination by a plastic surgeon + imaging diagnostics according to indications.

Sources used:

• FDA (USA) - labeling and follow-up: first ultrasound/MRI at 5–6 years, then every 2–3 years; what to do if symptoms occur.
  
  
• ACR Appropriateness Criteria (radiology) - which imaging method is appropriate when for implants.
  
  
• Long-term data (10-year cohorts) - MRI-confirmed ruptures and reasons for reoperations in different models.
  
  
• ASPS / FDA / MHRA (BIA-ALCL) - symptoms, diagnosis that prophylactic removal without symptoms is not recommended.
  
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