Breast implants, like all medical devices, do not last forever. The manufacturers quote anywhere from 10-15 years. Most patients will require replacement of their implants at that interval. The most common reasons to have implants exchanges are patient’s desires to change the size of their implants (usually larger), capsular contracture and/or implant leak.
Imaging studies, like MRI , can be used to detect “silent leaks” and are recommended every 3 years (FDA). Some studies have showed that high resolution ultrasound can be as effective in diagnosis of a leaking implant. At our breast health center, we routinely screen with ultrasound as it is a cheaper and easier alternative than MRI. Your medical insurance carrier may or may not cover this expense.
Saline implants do not require the regular imaging. If they leak, your body will absorb the saline (salt water) and the breast volume on that side will decrease. You’ll probably figure out that you have a leak before you see your surgeon.
Both saline and silicone implants have a rubberized silicone shell. Both are prone to leak, roughly at the same rate. Silicone has a higher rate of capsular contracture than saline. We are not sure why, but probably due to the absorption of the saline….
Silicone implants feel and look better, especially in women who have very little breast tissue.
Think of the the silicone implant as a high maintenance luxury vehicle (i.e. Ferrari), where the saline is like a good solid lower maintenance luxury car (think Acura). Not as hot as the Ferrari, but still a really nice ride!
Another option for breast augmentation is fat grafting and the BRAVA device. This avoids the use of implants.
In this procedure, fat is harvested from your body and transferred to your breasts. Prior to surgery, you wear a BRAVA device to enlarge the tissue prior to grafting. You wear the BRAVA device for 2-4 weeks. The surgery is longer and requires more preoperative preparation, but if you are a candidate, can average about 250-300cc augmentation. I am currently enrolled in the FDA study.
Here are a couple of videos on the procedure:
All the best.