I get this question from every patient I see in consultation for a breast augmentation, and even from those who have come to see me for something else.
“By the way,” they say, “I should talk to you about my breast implants. I need to get them changed out.”
“Do you like the way they look and feel?” I say.
“Yes, they’re great. But I have to switch them out every ten years, right?”
The short answer is: “No, you don’t HAVE to.” So where did this “replace every ten years” myth come from?
1) The implant companies used to offer a ten-year warranty on replacing your implants if they ruptured.
They offer this because even if your health insurance kicks in for the capsulectomies (removal of the scar tissue surrounding the implant), they will not cover the replacement implants if the first procedure was done for cosmetic reasons. The only exception here is if the initial augmentation was authorized for reconstruction, such as after a mastectomy in breast cancer, or for a congenital breast deformity such as tuberous breasts or Poland’s Syndrome.
If your implants are ruptured and you are relying on your health insurance to pay for the rest of the breast implant removal surgery, be prepared to have a Breast MRI or mammogram documenting the rupture before you see your plastic surgeon. Most insurance companies will demand proof of implant rupture before they will pre-authorize the removal.
Also, Insurance companies like Anthem and Aetna usually will not pay for removal of saline implants, even if they rupture. And while silicone implants could theoretically last you the rest of your life (although nobody will go on the record saying that), after ten years all bets are off with a saline implant. The shells really do start to weaken after ten years to the point where you could just wake up with one of them deflated and completely flat. Don’t worry—it’s psychologically traumatizing but not dangerous. The implants are filled with sterile physiologic saline that will just absorb back into your body. You should also know that saline implants deflate on their own about one percent per year, so if your implants seem to be getting smaller, that could be why. For instance, if you have implants filled to 500 cc, That’s fifty cc after ten years, which is about half a cup size.
But now, the two main implant companies in the U.S.—Mentor and Allergan—offer “lifetime” warranties on their implants. I’m sure this new company Sientra will do the same to keep up, since these guys always have to be neck-and-neck with their promotional deals. (See the First New Implants FDA-Approved post)
All of Allergan’s Natrelle® silicone implants automatically come with a Confidence Plus® lifetime warranty of the implants including $1200 toward out-of-pocket surgery expenses for whatever your insurance company won’t cover, for the next ten years. And, if you give Allergan an extra $100 within forty-five days of the your first breast augmentation, you are enrolled in the Confidence Plus Premiere® program, which gives you up to $3500 and a free implant for the other side if only one is ruptured for up to ten years.
Mentor® offers a similar program for their Memory Gel® implants—the Lifetime Product Replacement Warranty–and the comparable upgrade is free.
I realize that if you’ve read this far it’s just because you have implants and you’re trying to figure out what frequent flier plan you’re on. The bottom line is that if you got your implants in 2009 or later, they are lifetime guaranteed, but the extra money is only available for ten years after the first surgery.
See the following links for more information:
http://www.cppwarranty.com/warrantyInfo.aspx (for Allergan.)
2) The second part of my theory has to do with the typical “timeline” of a breast augmentation. Many women undergo breast augmentation in their early twenties, so by their late thirties-to-forties, after child-bearing and breast-feeding, they have developed capsular contractures, rippling or further sagging and need a lift, or want them bigger/smaller/looking “perkier” again. So they get them switched out because of the way they look, not because they have to.
Multiple studies have proven that there is no significant association with silicone and autoimmune disorders (see link http://www.ncbi.nlm.nih.gov/pubmed/18090815, Breast implant rupture and connective tissue disease: a review of the literature, Plastic and Reconstructive Surgery Journal, 2007 Dec;120(7 Suppl 1):62S-69S.)
So even if you find out that an implant is ruptured, it is not an emergency. The silicone isn’t going to leak all over your body and cause Lupus or connective tissue disorders. In fact, lots of women are walking around with old ruptured silicone implants and don’t even know it. The only thing that could happen is if the liquid silicone (and now we’re talking the second generation of silicone implants from the seventies and eighties) gets outside the capsule (the shell of scar tissue that your body makes around the breast implant) and into the breast tissue, you could develop hard little nodules called siliconomas. But even these will not hurt you. At the worst they can local inflammation and discomfort.
Siliconomas are rarely an issue anymore, since the third generation of silicone implants have been around for more than a decade—they don’t really leak since they have the consistency of Jell-O® (See my previous New Implants blog)
Okay, I think this is more than enough information for the rest of the week, but I hope it’s been helpful for at least some of you out there.