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Common Breast Implant Problems - When do they need to be replaced?

For many women, breast surgery and breast implants are a saving grace. They allow women the freedom to choose how their breasts will look and can correct any appearance issues.

Tagged: Body & Breast

Author: Mr. Bryan Mayou, MB ChB FRCS

Date: 2nd June 2021

Medically Reviewed by:  Mr. Bryan Mayou (GMC: 1414396)

Last reviewed: 7th February 2024

What is Breast Implant Surgery?

For many women, breast surgery and breast implants have a huge impact on confidence and self-esteem, leading to an increased quality of life. Breast implant surgery allows women the freedom to choose how their breasts will look and can correct any appearance issues.  

However, there are problems which can arise with breast implants, and it is important to know the signs to look for which indicate they need removing or replacing. There is a reduced risk of this happening if you have selected an expert in the field of breast surgery to carry out your procedure in the first place.  

Patients who undergo any procedure which involves breast implants need to ensure that they understand the signs of breast implant problems. Missing these could lead to medical complications.  

Breast implants don’t have an expiry date, but they rarely last a lifetime. It is reasonable to expect them to last 10-20 years. At this point, it may be time to consider the removal or replacement of old breast implants.  

Many patients won’t experience any breast implant problems after 10 years, but may wish to replace their implants for aesthetic reasons. 

What Are Breast Implants?

Breast implants are prosthetic medical devices that are commonly used in cosmetic surgery. The main function of breast implants is to adjust the size and shape of the breasts. These implants are usually filled with silicone gel or saline (sterile salt water). During your surgery, the breast implants are inserted into the breast tissue or under the chest muscle, depending on your desired result.

All breast implants used at Cadogan Clinic are made from silicone gel as they provide a more natural feel and appearance in comparison to saline implants. Saline implants have the advantage of being adjustable after surgery, with saline either being added to or removed from the implants to change the size of the breasts. However, they can often be seen under the skin and some patients find they can feel the water moving around inside them.

Your surgeon will discuss the placement of your breast implants in your consultation.  

  • If they are placed under the muscle (submuscular placement), the breast implants usually appear more natural, and there is less risk of visible rippling or wrinkling – especially in slim patients. However, submuscular placement can lead to a longer recovery time. 
  • Placing the implants over the muscle (subglandular placement) is well suited to patients who have well developed breast tissue and minimal sagging. The post-operative discomfort is usually less than submuscular placement, however subglandular breast implant problems include a higher risk of the texture of the implants being visible through the skin.

Silicone implants come in a range of sizes and shapes, to provide different amounts of volume and lift, depending on the final shape you are looking for from your surgery. Your surgeon will discuss your desired results and will then explain the best implant options for you.  

Breast implants are not permanent, and most patients will need them to be removed or replaced within 10-20 years. 20% of patients have their breast implants removed or replaced within 8-10 years. Factors such as ageing and changes in appearance lead to patients removing or replacing their breast implants.

Complications can also lead to removal, however by opting to have your surgery undertaken by a trustworthy surgeon in the UK, the risk of this is greatly reduced. 

What Are the Common Problems That Occur with Breast Implants?

By having your breast surgery carried out by expert surgeons such as those at Cadogan Clinic, the risk of any issues with your breast implants is greatly reduced. There have been rising cases of women experiencing breast implant problems after having surgery carried out abroad. Although having your procedure carried out abroad may be cheaper, unfortunately, it is hard to guarantee the quality of surgery you are undergoing.  

This is not the only reason for breast implant problems, there are several issues which lead women to seek Breast Implant Removal or Replacement. These include: 

Capsular contracture occurs when the scar tissue that forms around the implant, known as the capsule, tightens causing discomfort and changes in the appearance and feel of the breasts. This discomfort may be constant, or in certain positions, such as when you are bending over. Capsular contracture typically occurs due to inflammation which results in changes to the scar tissue within the breast. Factors that lead to this inflammation include:

  • A build-up of bacteria around the implant, known as a biofilm 
  • Implant rupture or leakage 
  • The build-up of blood (hematoma) or serous liquid (seroma) underneath the skin 
  • Individual immune response

Capsular contracture is a known risk associated with breast implants and your surgeon will discuss this with you during your initial consultation. Not all patients experience it and regular monitoring of your breast implants and any changes to your breasts can make it easier to manage or treat should it occur. 

Both saline and silicone implants can break, causing leakage or rupture. If saline implants rupture, the saline will reabsorb into the body, however you will require surgery to remove the shell. Rupture in silicone implants leads to the silicone leaking into the capsule and also requires surgery to remove the implant and the capsule.  

Saline implant rupturing often causes a very quick change in the size of the affected breasts. In comparison, silicone breast implant rupture symptoms can be more difficult to detect as the leaked silicone remains in the same area. However, the feeling or appearance of the breast may change. Periodic MRI scans are recommended to monitor your silicone implants and catch any signs of rupture or breast implant leakage problems quickly. 

PIP implants were manufactured by a French company - Poly Implant Prothèse. In 2010, it was identified that these implants had an increased chance of rupturing due to the use of unapproved industrial grade (rather than medical grade) silicone gel, which was not safe. The risk of rupturing can be between 2 and 6 times that of other implants. Leaving these implants in can cause some women to feel anxious and seek a breast implant replacement, even if they have not suffered any other issues or complications.

If you have had your breast implant surgery at Cadogan Clinic in the past 20 years, you can rest assured that your implants are not PIP as we have strict safety protocols, and these have not been used by our Clinic on any patient. 

Breast implant malpositioning occurs when the breast implants are not in the intended position within the breast pocket. This can cause the breasts to look uneven, cause discomfort or for the breast implants to move, for example flipping.  

There are different types of implant malpositioning including:

  • Bottoming out – this occurs when the breast implant descends below the natural breast crease. This creates a disproportionate appearance, with the nipple looking too high on the breast. It can be caused by poor breast tissue quality or the lower breast tissue not being fully supported. 
  • Symmastia – also known as uniboob, this occurs when the breast implants meet in the centre of the chest. It results from the implant pockets merging in the middle of the chest, leading to a lack of definition. It can be caused by the misplacement of the breast implants during surgery. 
  • Lateral displacement – this occurs when the breast implants move to the outer sides of the chest. The result is an overly wide space between the breasts. It may be caused by a lack of support to the implant pockets. 
  • Double bubble deformity – This occurs when there is a crease in the lower section of the breast, resulting in the appearance of two mounds. It is caused by the implant sitting too high or if the lower breast tissue does not have enough support. 
  • High riding implants – This occurs when the breast implants are positioned too high on the chest creating an unnatural, over augmented appearance. It is caused by the muscle underneath the breasts not being released enough, or the implant pocket having not been lowered enough. 

Temporary changes in sensation to the breast and nipple following the insertion of breast implants is normal and should resolve within a few weeks. In rare cases, these changes in sensation can be long term or even permanent. Changes in sensation can be influenced by the placement of the breast implants or the incisions used. Removing or replacing the breast implants may not solve these changes, and it is important to understand these risks when deciding to have any breast surgery. 

In some instances, patients may notice that they can see the texture of their breast implants through their skin. Although it is more common with saline implants, it can also occur with silicone implants. Placing the implants below the muscle can reduce the risk of this visible rippling thanks to the extra coverage the muscle provides. Patients with thinner breast tissue may be more likely to suffer from visible rippling. 

Some patients find that they are not happy with the appearance of their breast implants either soon after their surgery or many years later as age or other factors affect the appearance of the breast implants. It is very normal for patients to choose to replace their breast implants with a different size or shape which is more suited to their body in its current proportions.  

Which Procedures Involve Breast Implants?

Breast implants are used in a range of cosmetic and reconstructive breast procedures to alter the size and shape of the breasts. The four surgeries which involve breast implants that Cadogan Clinic’s expert consultant surgeons carry out are: 

Breast Augmentation, also known as Breast Enlargement or a Boob Job, is a surgical procedure which increases the size and enhances the shape of the breasts. Breast Augmentation is performed under general anaesthetic and takes 1-2 hours to complete.  

Your surgeon will make a small incision, most commonly in the crease underneath the breast, to create a pocket within your breast. The breast implant is then either placed over the chest muscle or under the chest muscle and the incision is closed.

The recovery from Breast Augmentation is usually 4-6 weeks, and you will have to wear a surgical bra for this period. Your surgeon will ask you to avoid strenuous activity or anything that could put strain on your incisions or your new breast implants. It is normal to experience some swelling and bruising during your recovery, and this may take a few weeks to resolve.

To view a selection of our patients' breast augmentation results, check out our breast augmentation before and afters gallery.

Also known as a Breast Lift with implants, Augmented Mastopexy combines traditional Mastopexy techniques, removing the excess skin that causes sagging breasts, with the insertion of breast implants to increase the size of the breasts and improve the shape of the breasts. It is a surgical procedure, performed under general anaesthetic which take 2-4 hours to complete.

Your surgeon will place the implants into your breast pocket, through an incision either in the crease below the breast or around the areola. They will then remove any excess skin and reposition the breasts into the desired position.

Full recovery following Augmented Mastopexy takes up to 8 weeks. Your surgeon will give you a comprehensive aftercare plan to follow, which will include wearing a surgical bra, to protect your incisions and reduce any swelling. You must also avoid any exercise or heavy lifting that could lead to complications that will affect your final results. 

Breast Reconstruction is a surgical procedure which restores the natural appearance of the breasts following Mastectomy surgery, usually involved in cancer treatment. Although the patient’s natural tissue can be used to reconstruct the breast, implants are often more suitable for slimmer patients who don’t have a substantial quantity of donor tissue. The length of the surgery will vary, depending on the extent of the procedure and the exact method used.

Breast Reconstruction can be performed in combination with Mastectomy or, at a later date, as a separate surgery. The implants can either be placed under or over the muscle – directly behind the remaining breast tissue. Your surgeon will advise on the breast implants that are going to create the most natural, realistic result for you.

Recovery following Breast Reconstruction is usually 6-8 weeks, although your surgeon will advise on your personal recovery timeline. You will have to wear a surgical bra and avoid any activities which put strain or pressure on your chest. If your Breast Reconstruction is related to breast cancer treatment, although your Mastectomy and Breast Reconstruction will be fully healed after a few months, you will still need to attend medical appointments to monitor your risk of breast cancer. 

Are There Any Immediate Side Effects From Breast Implants?

If your surgery is carried out by a reputable, qualified surgeon in the UK, your risk of complications and immediate side effects should be minimal.  

However, there are very rare instances of patients experiencing a phenomenon known as Breast Implant Illness (BII). The causes of BII are not fully understood, and some surgeons feel it is not a valid term.  

Symptoms reported by patients who appear to be experiencing Breast Implant Illness include:

  • Fatigue 
  • Joint and muscle pain 
  • Brain fog 
  • Hair loss 
  • Rashes 
  • Disturbed sleep 
  • Digestive concerns 
  • Food sensitivities

Many of these symptoms are non-specific and could be related to other health conditions which have occurred after the insertion of breast implants. However, if you have any concerns about the effects your breast implants are having on your health or wellbeing, it is important to speak to your surgeon. The vast majority of patients who have breast implants experience no issues or symptoms related to their breast implants. 

Are Breast Implants Permanent and How Long Do They Last?

Breast implants are not permanent. Patients who experience no issues or complications with their breast implants can expect them to last for 10-20 years. Breast implants have no set expiry date, so monitoring their lifetime often comes down to how the patient feels and any concerns they have.

The lifespan of implants can be affected by a number of factors, including:

  • Pregnancy and breastfeeding 
  • Weight changes 
  • Hormonal fluctuations 
  • Ageing 
  • Complications including implant position or capsular contracture

If you are concerned about the condition of your breast implants or are worried they are causing problems, contact us for a consultation with a qualified breast specialist, who will discuss your concerns and explain the best solution. 

Which Procedures Correct Breast Implant Issues?

When experiencing breast implant problems, patients usually wish to find the most effective solution. In most cases, this is surgical Breast Implant Replacement or Removal.  

Regardless of any problems, as breast implants are not permanent, it is likely that you will need to consider either removing or replacing them at some point in the years following your surgery.  

Although the typical lifespan of breast implants is 10-20 years, you may not notice any breast implant problems after 10 years.

Whereas Breast Implant Removal simply involves taking the breast implants out and sealing the incisions, Breast Implant Replacement involves exchanging your old breast implants for new ones. Breast Implant Removal or Replacement doesn’t need to be carried out by the same surgeon who originally inserted your implants.  

Patients undergo this procedure for a number of reasons including:

  • Exchanging their breast implants because they have reached the end of their life, 
  • They have decided they prefer a different look and want a different size or shape of implant 
  • They have suffered problems, and their implants need to be replaced for safety or comfort.

Breast Implant Replacement is a surgical procedure carried out with general anaesthetic. Procedure length will vary but usually takes 1-3 hours to complete.

Your surgeon will follow the same incision lines as were used in the original procedure to reduce further scarring. They will then remove the old implants and insert the new implants in the same position.  

Breast Implant Removal or Replacement may also involve a combined procedure called a Capsulectomy. This involves the removal or alteration of the capsule of scar tissue that forms around the breast implant. You will require a Capsulectomy if:

  • You have suffered a breast implant rupture – the capsule will need to be removed to extract any silicone that has leaked from the implant.
  • You are experiencing capsular contracture – if the capsule has become inflamed or is causing discomfort, it will need to be removed to resolve this. 
  • Your implant is moving or in the wrong position – in order to place a new breast implant in a position where it won’t move, the old capsule will need to be removed.

If you are experiencing any concerns or problems with your breast implants and you would like to speak with a qualified, experienced consultant breast surgeon, contact our dedicated patient advisors, who will answer any questions you may have and will organise a consultation for you at our surgical centre of excellence, based in Chelsea, London. 

Words From Our Founder

Mr. Bryan Mayou

It's important for patients to understand that breast implants have a limited lifespan. Typically, they may need to be replaced or removed every 10 to 15 years. However, certain issues such as rupture or capsular contracture may mean that earlier removal or replacement is required. Regular consultations with your surgeon are crucial to monitor the condition of your implants and address any concerns promptly. By staying proactive, we ensure the long-term safety and satisfaction of our patients.
Mr. Bryan Mayou

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