Do Breast Implants Really Need to Be Replaced Every Ten Years?

The question about whether breast implants must be exchanged at the ten year mark comes up constantly. The truth is more nuanced than the old rule suggests. Implants can wear down and rupture over time, but what happens next depends on the type of implant. Some of the most happy patients in my practicer are those I was able to reassure that their 10 year old implants did not need to be replaced. Much of our understanding of how long implants can remain reliable is based on the average length of time when increased rupture rates increased. 

With saline implants, a rupture causes the breast to lose its fullness quickly and is easy to detect. This can be both embarrassing and inconvenient, but is not dangerous. The saline is simply absorbed by the body. Options include having the other implant drained as a quick in office procedure or removed either in office, or in combination with a new breast surgery. With silicone implants, the issue is different. A rupture often causes a gradual change in breast shape. Over time, that change can create noticeable asymmetry or firmness. If these shape changes go unrecognized for years, they can be much harder to correct even with revision surgery. 

We do not have an exact time line on when implants might rupture. The 10 year number is based on the average length of time when increased rupture rates were increased for early generation saline implants. Today’s silicone implants are built differently. The fact is, implants can rupture early or late or never. Early detection is best. When a silicone implant ruptures, or when capsular contracture develops, the shape of the breast becomes less natural and often asymmetric. Although revision surgery can help, it is not always a guaranteed fix. Imaging methods, especially ultrasound are becoming more reliable to screen for rupture. A rupture itself is not the main safety concern with modern silicone implants. The more significant issue is the long term effect on breast shape. This means that routine replacement at ten years is not necessary for every woman. Instead, what matters most is recognizing early signs of change and addressing them before they become potentially permanent scar tissue changes that can make a future surgery difficult or impossible.

How Dr. Angela Keen Approaches This in Practice

Patients who notice any sudden or persistent change in breast shape should come in for an evaluation. An experienced breast surgeon should have access to in office ultrasound to help determine whether a rupture is likely. This situation is not a medical emergency, but it is something that benefits from timely attention, especially for patients who care about maintaining symmetry and a natural contour.

Dr. Keen advises her patients to stay familiar with their breast tissue and to come in with any questions or concerns. She also advocates routine imaging for breast cancer. She does not recommend mandatory implant replacement at ten years. For many women, their implants may last far longer without any issues. The priority is preserving breast shape and preventing long term problems, not following an outdated timeline.