BREAST AUGMENTATION: What You Need to Know About Your Breast Implants

Photo: Vital Agibalow

When it comes to breast augmentation surgery, getting implants is not a one-and-done operation. Yes, you’ll have those implants for quite sometime, but there’s going to come a point where they will most likely need to be swapped out. That’s why it’s important to follow up yearly with your doctor to make sure there are no problems.

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“Women need to be aware when they first get implants that at some point in the years ahead they’re going to have to get those implants redone,” says Dr. B. Aviva Preminger, a top plastic surgeon in New York City’s Upper East Side.

After a number of years, the integrity of the implant itself, along with the natural changes our bodies experience as a result of aging, are contributing factors when it comes to having breast revision surgery.

Dr. Preminger likens getting breast implants to buying anew car. “You’re going to enjoy them, they’ll get you where you need to go, but they’re eventually going to require a little maintenance,” she explains.

Because many women have their breast implants done when they’re younger, when the time comes to have them swapped out, they may not recall specific information pertaining to the implants which can be helpful to the surgeon. Not knowing this information, combined with implant malposition, scarring, and sagging of the breasts with time, can make revision surgery more challenging.

In an in-depth conversation, BELLA sat down with Dr. Premingerto learn more about breast implants, revision surgery, and why maintenance is the number one piece of information she stresses to all of her patients.

What are the different types of breast implants?

Traditionally, there are silicone and saline implants, which are basically sterile salt water. Silicone implants are pre-filled and come in specific sizes; saline are put in empty and filled up through a small tube.

The silicone implants feel more natural because they are a cohesive gel; saline is like a bag of water.Sometimes you can see more visible rippling with a saline implant than you would with silicone. And when saline ruptures, which may eventually happen since these are all man-made devices, the implant leaks with the saline becoming absorbed into the body and the implant deflates. With silicone, a leak is harder to pick up and is usually diagnosed on imaging.

In 1992, silicone implants were taken off the market for safety concerns, but the studies used to determine that information was found to not be based in any real science. Once it was determined that they were safe, they were put back on the market in 2006.


SILICONE: Made of a cohesive gel, this type of implant feels the most natural, like breast tissue.

SALINE: Comprised mostly of salt water, this implant can be thought of as a bag filled with water.

How would you advise a patient on which implant to choose?

It’s a totally personal choice. What I tell my patients is that they need to be able to sleep at night; if they have concerns about silicone, whether they’re actually based on science or not, they should go with a saline implant. If they’re looking for the most natural feel, a silicone implant is the better choice.

How often should patients have their implants checked?

Many women get them done when they’re young and forget what they actually have in. They don’t remember the type, the size, or the company, so it’s very important to follow up once a year. I don’t charge my patients for the visit because I want them to follow up.

How long after getting breast implants should they be swapped out, and why is it important to do so?

On average, breast implants last about 10-15 years, but that doesn’t mean you have to run to your surgeon at the 10-year mark. I do think once you get past the 15-year mark there is usually some disruption of the shell, and something may need to be done. And, of course, after the breast implants are swapped out, you’ll still need to follow up once a year.

When it comes to mammograms, should women with implants proceed in the same manner as women without?

I see patients afraid to go for a mammogram because of their implants, but you need to go for breast imaging the way you would if you didn’t have them. You’ll need to notify the mammographer that you have implants, and she’ll do something called an “Eklund view,” which is another way to look at the breast tissue around the implant. I put most of my implants under the pectoral muscle [implants can go above or below the muscle], which helps the mammographer as well.

What does the process of swapping them out require?

You can change the type of implant, and even the size. I have 3D imaging in my office, which allows me to show patients what they would look like with certain amounts of volume. They can visualize what they’ll look like a little bigger or smaller.

Something to also keep in mind—if you’ve lost some weight, been pregnant, or breastfed, that could contribute to the sagging of the breast, so you might need a lift at the same time as the implant exchange.

If the implants are intact, I go in, take the implant out, put a new one in, and do a lift if needed. The more complicated procedures come when they’ve had them in for a longtime and there are some issues—then it becomes a different kind of operation.

Is it a painful procedure, and what is the recovery time?

It’s generally not a painful procedure.When patients first have an implant put in, there can be some discomfort from the stretching of the tissue, which resolves fairly quickly. If all they’re doing is swapping out the implant either for a larger or smaller one, the stretching process has already happened so it’s not a particularly painful procedure. When there is more work to be done, patients may experience a bit more discomfort post-op.

What are your top recommendations to patients who are considering breast augmentation for the first time or looking to swap out their existing implants?

Most importantly, you want to go to a board certified surgeon. When considering revision surgery, it’s important to also go to someone with experience doing revision breast procedures. There can be cases—and I’ve had many—that are more challenging than a first time breast augmentation so you want to make sure you’re in the right hands.

Second, when you have breast implant surgery, the surgeon is supposed to give you a card containing all of the information of what they put in your body. If they don’t give you one, ask for it. Down the road, if you have a revision, the surgeon will want to know what you have inside, especially if there was ever an issue, such as a device recall.


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