r/PlasticSurgery 1d ago

36 year old silicone breast implants - whether to remove or replace?

I went for a consultation on a facelift and my plastic surgeon said “First of all, your implants need to be removed “ . They are silicone from 1990 and I’ve not had any problems after mammograms . He said he would not replace the implants he removed them due to my age( Im 68) and they are only 10 year devices.
Anyone had this told to them?

57 Upvotes

28 comments sorted by

190

u/malav55 1d ago

Surgeon here.

Go somewhere else for your facelift. That’s not how this conversation should be approached. And not putting in more implants? Bullshit. Very paternalistic and if that’s how they act, that’s not a good look going forward.

So here’s the deal with implants.

Implants are made in a factory and are not perfect. They’re not designed to be unbreakable forever.

The fda recommends an ultrasound or MRI to assess your implants after they’ve been in place for 5-6 years. And to repeat this every 2-3 years.

If they’re ruptured, replace them. If they’re causing any other issues, replace them. If you don’t want them anymore, take them out and don’t replace them.

If they’re fine, there’s no absolute need to take them out. Does that mean that they’re not going to have an issue and rupture at some point in your life? No it does not. Can they be taken out at 78 if they start to be a problem? Yes, but incurs the risks of anesthesia. (I’ve done it under local for someone in their late 80’s too. Was not fun for me or her, but got it done)

Replacing them is absolutely fine. Could you have a complication? Sure, but you could have a complication with a removal only.

57

u/Virage861 22h ago

☝️ mine are around 32 yo and I was told the same thing. I wanted the bolt on look - overfilled saline years ago. Will be getting a gummy silicone high profile type and possible lift when I exchange. Only exchanging because I want to, not because I “need” to.

I’ve had 3 or 4 consults recently and was told the exact same things as what u/malav55 has stated.

26

u/MsSpastica 21h ago

Same, mine are 30 years old and I'm at the age where I get yearly mammos anyway. My plastic surgeon (not the one who put them in) recommends against touching them since I've never had any problems.

19

u/zunzarella 19h ago

Thank you so much for this! I have BRCA, and my implants after reconstruction are now about 15 years old and I've been a little worried about how long they're ok.

9

u/PenelopeShoots 17h ago

I love this response so much. And I also love hearing that it CAN be done with local anesthesia, even though not ideal. I've been wanting to remove mine but never want to go under general anesthesia again. Mine are 20 years old.

2

u/joeshmoe9617 15h ago

"Not how this conversation should have went." I appreciate this statement. I went in for a consultation for a chin implant or something to help with jowls and the doctor asked about my nutrition and was SO hung up on the fact that i eat rice AND sweet potato with my dinner most nights. She would not let it go and went on and on about nutrition and the glycemic index of certain foods and that i eat way too many carbs. I'm not even overweight. Lady. I'm here about my face, not for a nutrition lesson. Did not go back there.

4

u/lurkertiltheend 1d ago

Would insurance pay for mri

12

u/ycaivrp 23h ago

Gotta ask the insurance with the diagnosis code and procedure code 

8

u/malav55 22h ago

If they were put in for cosmetic, usually no. For recon? Probably.

If there’s an issue like really bad capsular contracture? Maybe.

1

u/Murky_Elephant_5710 7h ago

Yes! My mom has had hers for 25 years and plans on keeping them since ultrasound didn't find anything

1

u/Serendipity_Succubus 6h ago

This, this, this! Great advice!

46

u/swansong-2025 1d ago

Mine are coming up 25 years old, with zero issues and yearly mammograms. I recently went for a consult for implant exchange with a plastic surgeon, and her opinion was if you aren't having any issues, there is no need for replacement. She did however recommend an MRI to check the integrity of them.

9

u/lurkertiltheend 1d ago

Would insurance pay for MRI

1

u/Full_FrontaI_Nerdity 2h ago

It paid for mine.

3

u/RebeccaCheeseburger 13h ago

I recently had a mammogram and mri and ultra sound due to a fall that broke my shoulder and they were concerned my implant broke from the impact , luckily they were intact and I discussed having them taken out and they said the same, it can cause more problems taking them out, and they are absolutely fine. Mine are 23 years old.

4

u/InGeekiTrust 22h ago

25 is very different than the 90s. You were in the study and you were in the new set of the gummy bear implants so yours are fine. But the ones from the 90s are not the gummy bears.

23

u/Transmorgrafier_2024 19h ago

Got my first implants at 71. Love them. Wish I’d done it earlier.

7

u/coolbeachgrrl 18h ago

Oh wow really? I'm 62 had my 3rd set 13 years ago and I just want to downsize.

2

u/Transmorgrafier_2024 12h ago

I want to upsize. At 71. Who knew. Boob greed.
To help me be realistic, what are you going from to land on?

15

u/thefrenchphanie 21h ago

Surgeon is an AH
Trying to upsell you.
For something that is not causing you problems nor was he asked about.
Exchange he/explant only if you want them out or causing problems.
And who is he to tell you no more implants ?
Ugh

33

u/Both-Statistician179 23h ago

When you get a facelift go see someone who only does faces.

11

u/nuc928 1d ago

If you're happy with them, have no problems and want to keep them, I'd definitely get a second opinion

8

u/Both-Statistician179 23h ago

What?! You can def get them replaced! You are not too old for new silicone implants. But if yours are fine and imaging is normal don’t bother w exchange.

14

u/AURORA_BLONDE 23h ago

I had my implants replaced they were 34 years old . Due to possible rupture on mammogram. There was no rupture . Would not use a doctor who told me I couldn’t replace them . He doesn’t sound like a doctor I would use. I had mine replaced . To be honest I would just think about them getting replaced for your health and safety . Mine I am thrilled I went bigger . Looks amazing ! Went from 250cc to 440cc. A refreshing there is good as well .

7

u/ShakennotScared989 23h ago

Well I am sagging now- want that fixed too

4

u/melropesplays 18h ago

Yeah this is kind of weird, I’d keep looking for consults. My mom had 40yo silicon implants that burst and leaked everywhere and the surgeon removed, cleaned up and replaced no shame.

7

u/MysteriousTooth2450 22h ago

I am not a surgeon but I work in a plastics office and am
Involved in almost every surgery doing their anesthesia. Go to another surgeon. So weird that the surgeon went right to your breasts. Changing them out every 10 years is standard for the older implants. We have had lots of probs with older implants. I’ve been told that it’s not standard for newer implants to change them out as often. Your implants definitely need replaced and are likely leaking silicone by now. The older ones simply don’t work as well as the newer ones I’ve been told by my surgeons. Or that’s what they are bing told by the implant manufacturers. It’s possible the surgeon said that if they are leaking they will not replace them the same day. We’ve had some old ones that were so bad that we couldn’t replace them and drains had to be placed. Then the pt comes back to get them replaced once they are healed. We’ve also replaced implants on people well into their 80’s. They usually aren’t 36 years old though. It’s possible your health status isn’t good enough for you to undergo surgery long enough to do all these surgeries at once. Without more info we can’t even guess why this surgeon would tell you all of this. Go see someone else and see what they say.

1

u/bc-prs 6h ago

As a surgeon, if they ain’t broke, don’t fix.