Is it possible to keep breast prostheses for life?

No, it is generally not recommended to keep breast prostheses (implants) for life. While breast implants are durable, they are not considered lifetime devices. Here’s why:

1. Lifespan of Breast Implants

• Average Lifespan: Most breast implants have a lifespan of around 10 to 20 years, although some may last longer without complications. However, over time, implants can degrade or develop issues that may necessitate replacement or removal.
• Rupture Risk: Both saline and silicone implants can rupture or leak over time. While a saline rupture is immediately noticeable (since the saline is absorbed by the body), a silicone rupture may go undetected without imaging, leading to a condition called a “silent rupture.”
• Capsular Contracture: Over time, some women develop capsular contracture, where the tissue around the implant hardens and contracts, potentially causing pain and distortion of the breast shape. This may require surgical intervention to correct.

2. Potential Complications Over Time

• Implant Rupture or Deflation: While rare, implants can rupture or deflate over time, requiring replacement.
• Capsular Contracture: As mentioned earlier, this condition involves hardening of the scar tissue around the implant and can cause discomfort or affect the appearance of the breasts.
• Rippling and Wrinkling: Over time, some implants may show visible rippling or wrinkling, especially in women with thinner breast tissue.
• Changes in Appearance: The natural aging process, along with weight fluctuations, pregnancy, and hormonal changes, can affect the appearance of the breasts, leading some women to seek implant revision or replacement.

3. FDA Recommendations

• The U.S. FDA suggests that breast implants may not be lifetime devices and recommends that women undergo regular monitoring, especially with silicone implants. For example, MRI scans are recommended after the third year post-surgery and every 2 years thereafter to check for silent ruptures in silicone implants.

4. Reasons for Implant Replacement or Removal

• Personal Choice: Many women choose to replace their implants due to a desire for a different size, shape, or type of implant.
• Complications: Issues such as rupture, capsular contracture, or infection may require implant replacement.
• Aesthetic Changes: Over time, factors like aging, pregnancy, or weight fluctuations may lead to sagging or other changes in the breasts’ appearance, prompting a desire for revision surgery.

5. Long-Term Considerations

• Regular Monitoring: Regular check-ups with your surgeon are important, particularly with silicone implants. Imaging tests like MRI or ultrasound can detect silent ruptures.
• Surgical Intervention: If complications arise, revision surgery (to replace or remove the implants) may be necessary. On average, most women will undergo at least one implant replacement or revision surgery in their lifetime.

Conclusion

While it is possible for breast implants to last for many years, it is generally not recommended to expect them to last for life. The FDA and most surgeons advise regular monitoring and the understanding that at some point, implant replacement or removal may be necessary due to natural wear, rupture risk, or aesthetic changes.