What are the long-term effects of breast augmentation surgery?

Breast augmentation involves the insertion of a prosthetic device into the body for a prolonged period of time. Based on this relationship, long-term effects center on the device, the body's responses to it, and the relationship between the two. No device lasts forever, and patients should be prepared to have the implant replaced every 10 years or so. The chance device failure, i.e. implant rupture, increases each year, so replacement is prudent as implants increase in age. Just as the implant changes over time, so do the breasts. Chances are, your breasts don't look the same every ten years, and so, your result may change over time. At the time of recommended implant exchange, many women (not all) desire a revision such as a mastopexy (breast lift), a larger or smaller sized implant, or a repositioning or capsule revision procedure. The "capsule" that forms around the implant vary from one patient to another, and among implant types. The etiology behind capsular formation is still controversial, but capsular contracture can compromise results. This capsule can form over time as the body has a low-grade, immunologic or mechanical reaction to the implant. Long-term effects tend to be of slow onset (except for rupture), and often require multiple surgical procedures. Therefore, the initial augmentation is seldom the only procedure a patient undergoes.

It is noted by both Mentor Corporation and Allergan Pharmaceutical, the only two manufacturers of FDA approved prosthetic breast implants in the United States, that breast implants are NOT lifetime devices. In fact, most women WILL need to replace their implants at least once in their lifes.

As a result, long-term effects may include the possibility of rupture of both saline and silicone implants, as well as encapsulation, referred to as capsular contracture. Specific changes to the breasts with both saline and silicone implant includes scar tissue formation around the implant referred to as a capsule. The capsule can become quite hard and require surgical correction under general anesthesia through a capsulectomy, removal of scar tissue, or capsulotomy, release of the scar tissue.

Capsular contracture and ruptured implants are the two most common chronic problems of women with breast enhancement surgeries over time. Other problems can include malposition with implants shifting, as well as skin laxity where patients may require a breast lift or mastopexy in order to remove skin due to the weight of the implants over time.

Breast implants will not last a lifetime. At some point you will need to have one or both implants replaced. Implants can tear or rip over time.  Since saline implants are filled with salt water, the implant will flatten and your body will absorb the saline. Gel implants are filled with a cohesive substance that will not leak like the saline implants. It’s harder to tell if you have a tear with silicone implants. Therefore, it is recommended that you get an MRI every 2 years to check for evidence of leakage.

Capsular contracture, or hardening of the tissue (capsule) around the breast may also occur. This condition can be painful and may result in deformed or misshapen breasts. You will likely need surgery to remove the capsule and replace the implants.

Another common long-term issue is sagging. Unfortunately, gravity is unstoppable. Over time your breasts may sag with the weight of gravity just like they would with natural breasts.  You can do your part to combat the problem by wearing a good supportive bra.