American Society of Plastic Surgeons
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Is it time for a breast implant exchange?


frequently asked questions about vaginal rejuvenation

Modern silicone gel and saline breast implants are long-lasting devices. However, no breast implant is made to last a lifetime. The rule of thumb used to be that your breast implants would last about 10 years before needing to be replaced, but that is not a hard-fast rule. Some patients safely have their implants for much longer.

The skin and tissues of the breast age just like the rest of you and, at some point, you are probably going to need to replace your implants. With that being said, that point is different for everyone.

Unfortunately, some patients develop a complication with their implants and/or the surrounding capsule that requires breast revision surgery. For the most part, however, women consider a breast implant exchange procedure due to a changing aesthetic.

Reasons for breast implant exchange

A breast implant exchange is one of those procedures with a number of different moving parts as there are so many different reasons why a patient may need one. It can be as simple as you just want to exchange your saline implants for silicone or vice versa. Or, though rare, your implant may develop a complication such as:

  • Rupture
  • Capsular contracture
  • Implant malposition

With saline implants, a rupture is self-evident as your implant deflates. This is less obvious with a silicone implant which is one of the many reasons why it is so important to see your plastic surgeon annually in order to check the health of your breast implants. MRIs are also recommended to check on the integrity of your silicone implants.

Capsular contracture is when the capsule of protective tissue that your body naturally develops around any foreign device, including a breast implant, hardens. Not only could this be painful, but it can also adversely affect the shape of your breast.

Implant malposition, like the name implies, is when your implant moves out of its original position because the skin and tissue of your breasts have weakened. It may drop below the inframammary fold, which is the crease beneath your breasts, or drift towards your armpit. Implant malposition is particularly common in women who perhaps got a larger implant than their anatomy could support.

Changing aesthetic big driver of breast revision surgery

One of the biggest drivers of breast revision surgery, however, is a changing aesthetic. If your original implants were placed in your 20s, and you are now in your late 30s or early 40s, you may no longer desire the same look. Fashions evolve.

Furthermore, your body may no longer look the same due to:

  • Pregnancy
  • Breastfeeding
  • Menopause
  • Age

Many women gain weight, particularly in their breasts, and may find they no longer need as big of an implant. The implant itself will likely not change, but the soft tissue around it will thin, age and sag. Some women even choose to remove their implants altogether. The right choice for you is going to depend on your individual anatomy and desired outcome.

In-person breast implant exchange consultation is critical

If you are thinking about changing your implants, it is critical to schedule an in-person consultation with a board-certified plastic surgeon in your area with a lot of experience in breast revision surgery. This is a procedure that sounds straightforward, but changing an implant is not as simple as changing a tire. During your consultation, your surgeon will assess the:

  • Status of your natural breast tissue
  • Skin tone and elasticity
  • Placement and health of your current implants
  • Nipple position

Together, you will discuss the best treatment options for delivering your ideal look. For many patients, this is going to include a breast lift.

Do you need a breast lift?

The simplest breast implant exchange procedure is when a patient with healthy breast skin and tissue just wants to replace her old implants with new ones that are the same size and shape. However, as discussed, most women who seek out this surgery are doing so not because their implants have aged to the point of developing a problem, but because they want a different aesthetic.

Lately, the trend with breast implant exchange has skewed smaller. While some patients still come in wanting to replace their current implants with larger ones, most want to go the other way The issue, of course, is that when you remove an implant and either don't replace it or replace it with a smaller size, you are going to be left with excess skin and tissue. In order to deliver the ideal contour to your new breasts, you will need to combine your breast implant exchange with a breast lift.

Fat grafting to the breast for improved shape

Fat grafting is another tool for improving the size and shape of your breasts. While some patients may be able to consider fat grafting as a stand-alone procedure instead of a smaller implant, for most, fat grafting to the breasts is a way to improve their shape. Your plastic surgeon may use it to conceal the edges of an implant in a very thin patient or to add more fullness to the upper pole of the breast.

Most women want a full, lush look in the upper half of their breasts. This is different than cleavage. The latter is dictated by your anatomy. Since any breast implant must be centered behind your nipple, your cleavage is determined by the distance between your nipples. However, adding an appropriate amount of fat to the upper half of the breast can help create that soft, full, feminine look that is so desirable today.


The views expressed in this blog are those of the author and do not necessarily reflect the opinions of the American Society of Plastic Surgeons.

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