Beauty requires maintenance. Having grown up with four sisters I know this to be a fact! I often wondered why they call the chemicals that made their hair curly a “permanent”, when it only lasted 3 months.

Back in the early 1980’s breast augmentation surgery exploded on the plastic surgery scene and the “go big or go home” motto was born. During this time Dallas was the show, the Cowboys were America’s team and there were three things that were the rage here in Texas: big hair, big cars and big…you know. We did a lot of Breast Augmentations but had limited appreciation for the long-term implications of aging implants and breasts. Now that I have been in practice 25 years, I have a better understanding of the challenges of maintaining an aesthetically pleasing breast shape and feel.

I am now seeing many patients who had augmentations 15-20 years ago and they present with a broad spectrum of issues:

· Breasts droop but implants don’t
· Weight changes affect breast volume
· Patient’s aesthetic goals change with age
· Implant failure/maintenance concerns
So let me talk briefly about each of these issues.

Yes, over time (thanks to gravity) breast tissue will droop or relax causing the nipple position to lower and the gland to sit on your upper abdomen. The implant, however, remains in place higher on your chest, which results in the snoopy dog appearance to the breast. The good news is this can be fixed but will require a breast lift to tighten the skin and reposition the nipple.

With each decade American’s tend to put on about 10 pounds. Weight changes will affect the look of your breast. When you have implants and gain weight the result can give you a top-heavy appearance. The easy answer to this is losing weight. The other option is surgical which is to downsize the implant volume.

If I have learned nothing else from 28 years of marriage it is that a woman has the right to change her mind! Like the tattoo you thought was really cool when you were 18, now that you are 50 you might have changed your mind. A woman’s goals for her shape change over the years and I have many patients who simply want to be a bit smaller. This can be as simple as an implant exchange or it may require a breast lift and exchange to a smaller volume implant.

All manufactured goods will eventually fail. This includes breast implants. I tell all my breast augmentation patients that implants are not permanent, may require maintenance and can fail over time. For saline filled implants failure is easy to detect because they simply deflate and the saline is absorbed. It is like a flat tire! The gel filled implant failure is more difficult to detect. Some women have a change in the shape and feel of their breast when the implant fails but many more are asymptomatic. As a result manufacturers recommend getting an MRI at 3 years post augmentation then every 2 years after that to detect a “silent” rupture. Physical exam is not reliable to detect a gel implant failure. Mammograms detect 50% of failures while ultrasound can detect up to 75%. MRI can detect 92% of ruptured implants.

All this to say you can go for 30 years with the same implants intact and be perfectly happy with their size and shape. But it is not uncommon to desire a change in size or type (saline vs gel) as your body changes.

Keep in mind the average life span of saline filled implants is around 12-15 years while gel filled implants probably last a bit longer approximately 15-20 years.

For more information and an appointment feel free to contact my office at (903) 535-7722 Cosmetic & Plastic Surgery Center-Tyler