The first use of breast implants as augmentation tools for the female breast came about in the 1960s. The early implants were very crude in comparison to what we have today. A breast implant is basically a silicone bag filled with either sterile fluid or a type of soft silicone.
Drastic changes in the composition of the contents inside the bag as well as the bag material itself have taken place. They are more durable, and more reliable today than ever before. However, implants that were put in place in the seventies and eighties have a higher likelihood of rupture and disintegration than the ones in use today. I have been inserting implants since the eighties. And, I have long-term follow-ups with patients who still have soft pliable non-ruptured breast implants.
Breast Implant Replacement
I have learned over the years that ultrasound, MRI, and CT scans are not always 100% reliable in detecting or determining if an implant has a rupture or not. In my opinion it really requires a surgical procedure to determine whether a breast implant has a rupture. Furthermore, I believe it’s been conclusively determined that breast implants do not in and of themselves cause cancer or autoimmune disease.
There have been recently incidents of a type of blood disorder associated with textured implants which personally I have never put to use in a long-term basis. Today’s implants have a warranty which expires in 10 years. Patients who I see sometimes ask “should I replace the implants that I have?” This requires the above-mentioned radiologic studies plus a good personal physical exam by me.
There is no exact way to tell if a silicone implant has a rupture or is leaking. However, they are often softer and have a loss of texture. Or a loss of integrity component different from the other side. That is should the other side be intact.
Breast Implant Types
Saline implants of course if leaking will go flat. This can be diagnosed usually very clearly. So, unless on physical exam I believe that a silicone implant is ruptured I would recommend no surgical intervention. However, unless the patient understands the above-mentioned information and wishes to either remove a larger breast implant or have them exchanged.
Another element to mention is implants that have been in place for 20 years may have a tendency to form calcified capsules. This can be treated with a complete and total removal of the capsule as well as the implant of course. Sometimes the calcifications are in isolated spots that can be removed as such. And, still use the remaining tissue of the capsule to re-augment the the breast. This is in addition to a new updated silicone implant.
In any event breast augmentation today is a far more reliable dependable and sophisticated operation creating a larger more aesthetic breast –– in most cases.
THOMAS TREVISANI, MD
BOARD CERTIFIED PLASTIC SURGEON
MEMBER AMERICAN SOCIETY OF AESTHETIC PLASTIC SURGERY
