Real Plastic Surgeons follow national and international scientific data published on short- and long-term outcomes and risks associated with breast implants. The safety of breast implants has been a matter of debate and concerns for decades.
Realplasticsurgeon.eu have decided to publish a series of contributions from Real Plastic Surgeons with the focus on patients’ most frequently asked questions. This article focuses on the long-terms effects of breast implants. We asked realplasticsurgeon.eu member Dr Nora Nugent for her views and recommendations. Here is what she has to say:
1. How long will my breast implants last?
The average time that breast implants are left in place is 10 to 15 years. This means that most women will consider changing their implants 10 to 15 years after first getting them placed. This is the average time. Some women have implants in place for much longer without problems, while others need to replace them sooner.
2. Why do breast implants need to be replaced?
There are many reasons why a woman may want to replace her breast implants. The most common reason is that she no longer likes the look of her breasts. This is generally caused by the natural changes of the breast with aging (see point 5). Sometimes complications can occur causing changes that should be corrected with an implant change. The most common and significant reasons are explained below. The reasons essentially are either a problem with the implant, a change of your breast tissue over the implant or less commonly a change of mind regarding having implants.
3. What are the most common or significant problems that can occur with an implant in the long term?
a. Capsular contracture
When a breast implant is placed, your body will build a membrane or capsule around it. This is normal. If the capsule becomes thicker and/or tighter than usual, this is called a capsular contracture. If this happens, your breast will feel firmer. The next stage is that they become harder and the tight capsule may be visible and alter the shape of your breast. In the last stage, your breasts may be uncomfortable and painful. Treatment is to surgery to remove the thickened capsule and if desired to replace your implant. Plastic surgeons work very hard to understand the reasons behind this and the rate of capsular contracture is improving compared to past rates.
b. Implant rupture
Breast implants are very durable and made to last a long time. Most have a silicone outer layer with silicone gel inside. However, at times the silicone shell of the implant can rupture or tear. This usually all happens within the capsule that develops around the implant but can involve breast tissue outside the capsule. Treatment is surgery to remove the ruptured implant and usually the capsule around it. New implants can usually be placed at the same time.
c. Implant position change
While implants are designed to sit behind your breast tissue in a central position, sometimes they can sit too high, too low or too far to one side. If this happens to a significant extent, the position may need to be adjusted with surgery.
d. BIA-ALCL
This stands for Breast Implant Associated - Anaplastic Large Cell Lymphoma. It is a rare lymphoma (type of cancer) that is associated with breast implants. It appears to be associated with implants that have a textured (roughened surface). Most commonly fluid around an implant forms with or without a lump in the capsule that is made around the implant. It usually occurs several years after the implants were placed. Treatment is removal of the implant and the capsule for most women. Some have needed chemotherapy if the BIA-ALCL was more advanced and a small number of deaths have occurred. This is an ongoing area of research within plastic surgery and more information is likely to be available in the future regarding BIA-ALCL.
4. How would I notice a problem with my breast implant?
Signs to have your implants checked if they happen include; a change in shape, a change in how your breast feels, an unexplained swelling (fluid or in your breast tissue) or pain in your breast.
5. What changes can happen in my breast tissue over time?
Ageing, weight changes and hormonal changes e.g. during pregnancy, breast-feeding or menopause all affect breast tissue. Breasts gradually lose support and may change in size and/or shape as a result of these changes. They may also drop or sag. This can happen regardless of having breast implants or not. Over time the weight and stretch of a breast implant can stretch your breast tissue too or cause it to drop. This happens more with large implants.
6. What does Real Plastic Surgeon member Dr Nora Nugent recommend for women with breast implants?
The International consensus is that women with breast implants stay in regular contact with their plastic surgeon and have regular checks of their implants. In addition, they should contact their plastic surgeon if they notice any change or problem with their breasts. MRI and ultrasound scans can also be helpful for additional information regarding implants in place.
Dr Nora Nugent FRCSI (Plast) for realplasticsurgeon.eu