Neither saline nor silicone breast implants have an expiration date, and some women enjoy their breast implants for more than 20 years. However, these medical devices should not be expected to last a lifetime.

Over time, the silicone shell that contains the saline or silicone implant material begins to weaken. This makes the implant shell increasingly susceptible to ruptures, which can cause unwanted medical and cosmetic issues.

For many women, proactive implant removal with or without implant replacement is preferable to being at a higher risk for ruptures and leakage. Depending on the implant, removal may be recommended after 10-15 years, though there are variances between implant types and other considerations that factor into the optimal time for removal.

When a saline breast implant ruptures, the sterile salt water inside the implant shell leaks out and into the body. Saline implant ruptures are easy to diagnose due to the pronounced visible changes in the appearance of the affected breast, which will look deflated.

Since the body can safely absorb saline, there is no health risk when this happens. However, breast implant removal is a necessary step in the restoration of natural-looking breast contours after a saline implant rupture.

Silicone ruptures are frequently referred to as silent ruptures because quite often, there is no discernable volume loss or change in shape, and the patient is completely unaware of the issue.
Silicone implant material is thick and cohesive enough that it often retains its shape even when the shell around it has ruptured. If silicone leaks out of the shell, it typically remains within the capsule of scar tissue that naturally forms around a breast implant in the weeks following its initial surgical placement.

A ruptured silicone implant is not considered a medical emergency. However, a timely breast implant removal procedure is advisable since the leaking silicone is not indicated for direct contact with bodily tissues.

Physical discomfort and/or medical conditions can arise due to silicone implant ruptures and leakage. Pain, swelling, and chronic fatigue are common symptoms of leaking silicone implants. Additionally, sensations of numbness, burning, and/or tingling can occur, and some patients develop hard lumps in the affected breast tissue.

Breast implant illness refers to a broad set of symptoms experienced by patients who have an adverse reaction to their implants. Symptoms of an inflammatory or autoimmune response may be induced by saline or silicone implants and can include:

• Cognition issues such as difficulty focusing, anxiety, fatigue, and memory loss
• Musculoskeletal issues like muscle and/or joint pain and muscle weakness
• General body symptoms such as rashes, chronic pain, dry eyes, and hair loss
  Breast implant removal is considered the best treatment option for resolving BII symptoms.

Capsular contracture refers to complications that arise when the body overproduces scar tissue in response to implant placement. Scar tissue is an inevitable by-product of the healing process after the placement of breast implants. The formation of capsular scar tissue around a breast implant is not only a natural response to the device, it is also beneficial, as it helps to secure the implant in place.

Capsular contracture occurs when the body registers an implant as a threatening foreign object. The formation of thick, irregular scar tissue around a breast implant is the body’s way of isolating the implant and neutralizing the perceived threat.

Capsular contracture is given a grade of 1-4 to indicate the severity of a patient’s symptoms and indicate whether breast implant removal surgery is required to alleviate discomfort and/or palpable irregularities:

• Grade one denotes an asymptomatic case that will not jeopardize the success of breast implant surgery.
• Grade two capsular contracture is associated with minor cosmetic concerns that do not distort the breast shape but will contribute to palpable, yet mild, firming.
• A designation of grade three is applicable when the breasts no longer feel or look natural due to more advanced hardening. Many grade three capsular contracture patients will need implant removal surgery to resolve concerns relating to breast shape and the density of hardened tissue.
• Capsular contracture cases classified as grade four are characterized by unnaturally hard and severely misshapen breasts, as well as significant pain in the breast area. Breast implant removal will be needed in the vast majority of grade four cases of capsular contracture.

Implant displacement, or implant malposition, refers to a breast implant that has moved out of its intended position on the chest wall. One type of implant displacement involves the lateral movement of breast implants toward the center of the chest. The medical term for this condition, which can ultimately result in a “uniboob,” is symmastia.

A patient’s genetics and anatomy can play a role in the development of symmastia. However, muscle detachment due to overly aggressive tissue dissection during an implant placement procedure is most often the cause. Correcting this condition and restoring natural-looking breasts requires removing the implants in addition to muscle and tissue repairs.

Malposition can also occur due to oversized implant pockets, which are associated with two types of implant displacement. If implant pockets are too large, breast implants can shift laterally until they are abnormally far away from the middle of the chest.

Implants can also rotate if placed in overly large implant pockets. While the rotation of round breast implants may not cause any noticeable effects, rotated teardrop implants create severely distorted breast contours.

Some patients find that their enhanced breasts do not appear and/or feel like natural breasts because of ripples or wrinkles that have formed in the implants. In some patients, such as those with thinner skin, ripples can create visible abnormalities. Implant wrinkles can also be palpable, prompting a patient to pursue breast implant removal in Beverly Hills to restore a softer, smoother feel.

Breast implants that are too heavy or large to be properly supported by a patient’s tissue can sink below the breast crease to cause various cosmetic concerns. When implants “bottom-out,” the nipples do not descend with them but instead move upward, creating an unnatural breast appearance. The outline of a breast implant can become noticeable due to bottoming-out as well.

Patients can elect to have their breast implants removed even if their implants have retained their structure and integrity, as well as their intended position. Some women find that their aesthetic preferences evolve over time and that smaller, natural breasts are more in alignment with their current lifestyle and desired physique.

In other instances, patients want to exchange their breast implants for implants of a different type, shape, size, and/or firmness. A breast implant removal with replacement procedure can be performed in these cases.