What Happens if Breast Implants Aren’t Replaced?

May 26, 2021

Our board-certified plastic surgeon, Dr. Steven Yarinsky, explains that while breast implants last for many years, they should not be considered lifetime medical devices. They can rupture or leak, and saline implants may deflate. Capsular contracture may also occur, which is shrinkage of natural scar tissue that your body produces around any implanted medical device. This may result in firm or hard breasts or a deformity which you can feel or see. Since the implants are not designed to last a lifetime, they may need to be replaced after about 10 to 15 years on average. With that said, if implants are “up and running,” are intact, and not creating any problems, there is no need to replace them. We have many patients who have had their implants for over 20 years without problems.

If hard breasts or capsular contracture develops, treatment options include removal of the thick scar capsule with or without replacement of the implants. If saline implants rupture, the salt water filling in the implants is resorbed, resulting in a “flat tire” appearance. Leaving deflated saline implants in place can result in further capsular or scar tissue contracture and visible deformity of the breasts. So, it is recommended to have saline implants replaced within a month or two of deflation. If silicone gel-filled implants (also known as “gummy bears”) rupture, no change in breast shape or size may be seen, but the affected breast may feel softer. Therefore, after silicone gel implant placement, a breast ultrasound or MRI study should be done every 5 to 7 years to rule out a “silent rupture.” If the shell of a silicone gel implant breaks, loose silicone oil can escape. While there is no scientifically recognized harm to the body from loose silicone gel, the implants are designed and approved by the FDA to be used with an intact shell surrounding the gel fill material. Though there may be no change in the breast appearance, out of an abundance of precaution and with patient safety first in mind, it is recommended that broken gel implants be replaced or, if desired, removed without replacement.

As some patients consider getting their implants removed—whether due to a mechanical complication such as implant shell breakage, capsular contracture or personal choice—the question often arises of whether they should exchange their implants or return to their natural breast size.

Enlarging breasts with implants stretches the overlying breast skin envelope, increasing the amount of breast skin. If implants are removed without replacement, there is often a breast volume and skin mismatch causing breast droopiness or “ptosis.” Due to this fact, for those interested in breast implant removal without replacement, their breasts may not look the same as they did before undergoing breast augmentation. A woman’s age, implant size, and the length of time implants are present can all cause changes that may not be noticeable until the implants have been removed. For instance, the weight of a larger implant and gravity effects over the course of several years can gradually cause the skin and breast ligaments to stretch, leading to sagging tissue.

For those women who choose to remove implants without replacement, to address the loose skin breast ptosis that results, Dr. Yarinsky often recommends a breast lift to remove redundant loose skin and tighten the ligaments. This helps to produce a more youthful and shapelier breast appearance, avoiding a “deflated” look. Women who have good breast skin elasticity and smaller implants may find that after implant removal their breasts return to a similar size and shape as they had before breast augmentation.

The best way to know how your breasts will look after breast implant removal without a replacement is to schedule a personalized consultation with a board-certified plastic surgeon. Dr. Yarinsky utilizes Crisalix 3D and 4D imaging technology to help patients by simulating and previewing their projected results.

If you would like to learn more about this type of breast revision surgery with or without an implant exchange, please contact Saratoga Springs Plastic Surgery to schedule your personal consultation with Dr. Yarinsky. He will help you understand what you can realistically expect after implant replacement or removal, and how to achieve results that help you to feel beautiful and confident.