In the mid 1990s the silicone gel filling in implants changed from a liquid which looked like Golden Syrup to more like the inside of a jelly bean. In the old liquid implants, a tear in the outer shell (often called a rupture) meant that the liquid was released into the capsule of scar tissue surrounding the implant. Usually that resulted in a hard capsule developing around the implant, producing a small and shrunken breast. Rarely, the liquid silicone would escape from the capsule and form hard lumps in the breast tissue and armpit known as silicone granulomas.
The modern `jelly bean’ or cohesive gel implants became available in Australia in the early 2000s, so if your implants are more than 20 years old, the chances are that they’re liquid. It was advised that the liquid implants should last ten years and then be replaced, so if your implants are 10+ years old, it’s a good idea to come and see me to have them checked out.
We know that modern implants don’t leak like the old liquid ones, but nevertheless might need replacing for several reasons. Most manufacturers recommend an MRI scan to check that the implants aren’t ruptured 10 years after surgery (except in the US, where it’s every 2 years). Ultrasound examinations are generally not very good at detecting a rupture, and in some studies are only 50% accurate compared to 90% accuracy under an MRI.
We don’t actually know how often implants rupture; mainly because not everyone comes back for their 10 year scan. Why would you pay $300 if you think your breasts are OK? Some manufacturers quote around 1% at ten years, but really that’s just a guess based on studies where they have followed a series of women for a while.
Does a ruptured modern implant actually cause any harm? Probably not. We know that the gel remains in the capsule most of the time because it is so cohesive and studies that examine how much is absorbed into the blood stream show the answer to be very little. Silicone is the fourth most common element on the planet and is in everything from food to cosmetics to hair products. I heard once that you absorb five times more silicone from hair conditioner than you do from a ruptured implant, but I think that was just marketing. Interesting dinner party fact: Did you know that almost all the medical grade gel for breast implants for the whole world comes from a single factory in Costa Rica.
So what’s the bottom line? If your implants are more than 20 years old, get them changed. If they are 10 years old, get an MRI, and if something has changed in the shape of your breast without good reason, get them checked.
Tomorrow I am going to talk about other reasons to remove and replace implants.
Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.