FAQ’s About Breast Implants by Dr Edwin Pound in Atlanta

 FAQ’s About Breast Implants

-Win Pound, M.D.
  1. How long do breast implants last?
I am always asked if implants need to be replaced every ten years. I believe people tend to get that number based on the “warranty” on the implants. In my mind, as we say in the south, “if it ain’t broke, don’t fix it.” I have seen saline implants last as long as 29 years before breaking and some of my dad’s silicone gel patients have had their implants for 35-40 years.
  1. How can you tell if one breaks?
If a saline implant breaks, you will have a “flat tire” within a matter of days. The saline will leak out quickly and be absorbed. You will notice the resulting volume discrepancy between your breasts. A rupture in the newer cohesive silicone gel implants may be a little more difficult to detect. When the FDA returned the silicone gel implants to the market in 2006, they recommended that patients get an MRI three years after implantation and every other year after that. The problem is that MRI’s are very expensive and they are not 100% accurate. Cohesive gel tends to hold its shape even in the presence of a large rupture so, again, unless there is a clinical problem associated with the implant, an undetected rupture in a silicone gel implant should not be a problem.
  1. What if I decide to take them out later?
Removing volume (the implant) from a breast is kind of like removing fat from the thigh. The skin does not spring right back immediately but takes some time for the elastic fibers in the skin to tighten down. Just as I do with my liposuction patients, I advise my implant removal patients to wear something compressive for two to three weeks following their surgery.
  1. Will removing my implants make my breasts sag?
Not necessarily. Removing the volume from the breast will make the nipple/areola move towards the chest wall rather than downward. I tell my patients that their breasts will look essentially like they do prior to removal, just smaller in volume.
  1. Which is better, saline or silicone gel?
There are pros and cons to each. To me, silicone gel more closely approximates the feel of real breast tissue. Saline implants are essentially a bag full of water and have the potential to look/feel like a bag full of water. On the flip side of the coin, saline implants are less expensive and the volume can be adjusted during surgery before the fill tube is removed. Silicone gel implants come pre-filled and therefore cannot be adjusted.
  1. Which looks more natural, over the muscle or under the muscle?
If the surgery is performed properly, it should look natural in either position. Initially, the tissue over the implants will be tight and the implants may sit high. This will loosen up over time. I tell my patients that, when implants are above the chest muscle, they may see their final results in two or three weeks. When the implants are placed below the chest muscle, it may take as long as two or three months for everything to settle and soften up.
  1. My breasts are sagging. Will implants lift them up?
Implants provide volume. That is all that they do. There is nothing about an implant that can lift a breast. That requires a breast lift procedure.
  1. What will happen to my implants as I age?
Your breast tissue is affected by a number of factors over time – weight gain/loss, periods, pregnancy, etc. These are changes to your breast tissue which are difficult to predict. The implants themselves will not change. They are just along for the ride. The addition of implants should not cause your breasts to sag over time unless you go with really large implants that overwhelm the suspensory ligaments in your breasts.

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