All breast implants will eventually wear out, so how do you know when it is time to replace them? Well, that depends.
When saline implants rupture, they will deflate like a flat tire and your body will reabsorb the water that was inside of them. So if you have saline implants, you do not need to check on them; you will know when they have ruptured by the way they appear. However, if your implants are over 20 years old and you do not want to be caught by surprise, you might want to think about replacing them. For some reason, they seem to deflate right before people’s children get married!
If you have silicone implants, a rupture will not necessarily be obvious right away. Silicone implants are recommended to be screened for rupture with either ultrasound or MRI after 5 years and then every 2-3 years after that. If you have your implants placed by me, I offer complimentary follow-up ultrasound screening to all of my patients. However, the ultrasound only gives information on whether the implant is ruptured at that time; it doesn’t tell you if they are about to rupture next week.
There are two strategies to replacing silicone implants. One way is to preemptively replace them at some point in time that you feel comfortable with (let’s say, 15 or 20 years). The advantage of replacing implants before they rupture is that it is a pretty quick and easy procedure. However, it is still surgery, and if you go with this plan, you may end up having more surgeries over your lifetime than you might have needed otherwise. The other strategy is to wait until the implant does rupture, and then replace the implants. This minimizes the potential number of surgeries you will need over time. However, once the implant has ruptured, you might need to undergo a more involved procedure like a capsulectomy, which is removing the scar tissue around the ruptured implant. There isn’t a right or wrong answer; it just depends on your preference and timeline for future surgery.