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Dr John Di Saia, an orange county california plastic surgeon

"I Have Hard 20 Year Old Breast Implants?"

Silicone gel implants were first used for cosmetic breast surgery in the early 1970's. Saline-filled implants were added in the late seventies or early eighties. Over time silicone gel implants tend to leak certainly by the twenty year mark. This is frequently associated with breast hardening (contracture) although it happens very slowly in most cases. This occurs so slowly in fact that most women do not realize how hard they were until after they have had them replaced and the scar capsules removed.

It is natural for women with these old implants to wonder what they should do with them. As you might imagine, there is no one answer for all women. It depends upon the current condition of the implants and the breasts in which they reside as well as the woman's preferences. Not all patients need do anything except regular breast cancer surveillance - regular mammograms, physical exams, and possibly breast MRIs. Really old implants probably should be at least removed however. For ladies considering additional surgery to fix the problem, here is a brief list of options:

[A] Removal of Implants and Scar Capsules Without Replacement - The implants are removed along with most or all of the scar capsules around them. Simple implant removal is possible, but is usually an inferior choice.

[B] Removal Of Scar Capsules Along With Implant Exchange - This puts back the volume of the previous breast implants with either saline or a silicone gel-filled implants. Patients who have had silicone gel tend to feel a difference with saline-filled implants. Some of them want saline for piece of mind. The choice is personal.

[C] Additional Breast Lift - For women with droopy breasts or those wishing to reduce breast implant volume, an additional breast lift can "take up the slack" making a more youthful-appearing breast with less sag.

[D] Additional Breast Reduction - For women who might have gained weight since their implant placement, breast volume can be "naturally" large that reduction even after implant removal can be in order.

About Secondary Silicone Breast Implant Surgery

Secondary silicone breast implant surgery is exactly that, a revision by design. Your results from this kind of surgery vary dependent not only upon your surgeon's skill, but also the degree of distortion and scarring and your choice of surgical procedure. Simple implant removal may leave deformity although this can be minimized. Minor additional procedures are not universal, but are occasional to improve the result.

The Beauty of Saline Implants

Women with older saline implants are far more commonly able to just leave them alone. As long as the breasts are soft, there is far less worry about delayed breast hardening which is much more common with the silicone gel implants. Women who have had both saline and silicone gel implants over time are more difficult to predict in this regard.


© John Di Saia, MD... an Orange County California Plastic Surgeon       

Serving Southern California since 1997 * (949) 369-5932


Please note that this resource is offered freely to individuals considering cosmetic breast surgery. No rights are granted and it is not to be reprinted or copied without the author's prior written consent. Understand that some of the information presented may be a matter of professional opinion. Although efforts have been made to assure accuracy, no guarantees are expressed or implied.