We at Orange County Plastic Surgery see many patients who had their implants inserted elsewhere and are happy to do that for any patient on an annual basis, as a complimentary service.
The “How long do implants last” question is a little more difficult to answer. I will start by telling you what happens when an implant gets inserted and why an implant eventually ruptures. It is normal for a body to make a thin layer of scar tissue around every foreign device that is inserted, be it a chin implant, a knee joint, a breast implant or a pacemaker. If one were to look inside the pocket around a breast implant, one would see a thin layer of scar tissue, the so called “capsule”, that, from the inside, is smooth, soft, whitish and looks like the inside of a plastic bag. An implant is a loose, floppy bag that has folds in it. Normal movement inside the pocket can cause the shell to fail anywhere along a fold. After implants have been in place a long time, let’s say over fifteen years, the body may begin to deposit calcium in this scar tissue around the implant. These calcium deposits grow in size and begin protruding into the pocket housing the implant, just like stalactites and stalagmites grow into an underground cave. Once this occurs, very frequently with implants that have been in place for twenty or more years, the roughened calcium deposits cause the implant shell to rupture.
It is our strong recommendation that all implants which have been in place for twenty years be replaced.
Breast implant surgery is so popular because there is a high patient satisfaction from such procedures.
The important thing to take away from this discussion is that implants are safe and rarely lead to problems if inserted properly and if replaced before the twenty year mark comes up.
Let me show you an example of an implant I removed this week from a patient who had some firmness but otherwise felt fine, some 30 years after the implants were inserted.
Particularly when doing an uplift at the same sitting (i.e. long incisions are necessary for the uplift, making it easier to remove the capsule), it is desirable to remove the old implant, surrounded by an intact layer of scar tissue, in one piece, like a softball. This will prevent any loose silicone from spilling into the surgical field. Spilled silicone can be removed from a surgical site, just like oil can be removed from a beach or honey from a broken jar can be cleaned from a kitchen floor but it is difficult to do so – the trick is not to spill anything and to avoid the difficult and messy clean up. After removing the implant and scar tissue in one piece, a new implant can be inserted. In this patient, I opened the scar pocket after the operation had been completed.
In this case, as we began opening the scar pocket, you can see that the implant had ruptured and free gel was present in the pocket!
Finally, after I opened the pocket and removed the broken implant and free gel, I turned the scar pocket inside out, the same way you would turn a sock inside out, to show you what was inside the pocket, rubbing against the implant. Note the heavy sheets of jagged, sharp calcium deposits along the upper half of this opened pocket. The bottom contains smooth, soft scar tissue and looks like any healthy lining inside a relatively new capsule. It is these sharp calcium deposits which rupture most old implants.