How Old to Get Breast Implants: Women’s Concerns About Silent Rupture

Breast augmentation with implants continues to be a popular cosmetic surgery procedure performed in the year 2020. If you’re Googling, “how old to get breast implants?” you should know that the FDA  has approved saline-filled breast implants in women aged 18 or older, while you have to be 22 or older to get silicone gel-filled breast implants. When you make the choice to get a breast augmentation, you deserve to know exactly what’s going into your body and how it will affect you. 

Breast implants are designed to last many years, and their designs and shapes have evolved over time to reflect women’s changing desires and goals. But one thing that hasn’t changed? Women want to know what’s happening inside their bodies. They want to know that their breast implants are intact. But there are still breast implants on the market today that don’t alleviate women’s concerns. Silicone gel-filled implants have the potential to rupture silently and a woman won’t know about it for weeks, months, or even years. Another concerning factor is that some plastic surgeons don’t inform women about the possibility of silent rupture and act like it’s not a big problem. 

Women are Concerned About Silent Rupture

All breast implants have the potential to tear or rupture, but silicone gel-filled breast implants are the only ones that do so silently. The FDA states,

“If a silicone gel-filled breast implant ruptures, it is not likely that you or your doctor will immediately notice because most silicone implant ruptures are without symptoms, ‘silent ruptures’. A silent rupture doesn’t change the way an implant looks or feels, so your surgeon or health care provider may not be able to detect a silent rupture by a physical examination alone.” 

Silicone gel-filled implants can rupture at any time after they are placed, and the longer you have the implant, the higher your chances of rupture. A recent independent survey asked 933 women ages 25-45, (of which 45 percent are registered nurses, with 108 women in the aesthetic surgery industry, and 102 female physicians) how they felt about silent rupture. Survey findings showed:

  • 98% of women said they would be concerned about silent rupture with silicone gel implants.
  • 95% of women say they would want a ruptured silicone implant removed, even if they didn’t show symptoms

At an American Society of Plastic Surgeons conference, California-based plastic surgeon Dr. Vivian Ting shared the results of three surveys of 1,143 women with almost identical findings. Survey results showed that 97 percent of women want to know if their silicone gel implant has ruptured, with 95 percent of women wanting the faulty implant replaced even if it’s not causing symptoms. Dr. Ting believes it’s important to share these survey findings with other plastic surgeons to make them aware of just how substantial women’s worries are. “The surveys clearly showed that the majority of women have very real concerns about silicone gel in their bodies and the risk of silent rupture,” she said. “Surgeons may underestimate this anxiety simply because they don’t share the concern, in great part because 90 percent are male. Yet a woman’s anxiety about what is in her body is a critical part of the full treatment picture.”

Over 10 years, silicone gel-filled implant had very high rupture rates, with Mentor gel-filled implants rupturing 24% of the time. Dr. Mathew Plant, a board-certified plastic surgeon in Toronto, says “Patients have aesthetic surgery to feel better about themselves and gain some confidence that they may be missing. So the last thing that I ever want to do is put a device into someone that then gives them a whole bunch of new anxieties and keeps them up at night. If all we’ve done is trade one insecurity for another then we haven’t really accomplished anything at all.”

Silent Rupture Detection: is it Reliable?

The only way to find out if your silicone gel-filled breast implant has ruptured is by obtaining an MRI or ultrasound scan. The FDA recommends women get these imaging procedures every two to three years after breast augmentation. This is an out- of-pocket expense (not covered by insurance) that can cost between $444-$1468. This is in addition to the money already spent for the initial breast augmentation. Out of the 933 respondents, 89% of women surveyed reported they were “less likely to choose silicone gel” after learning of the FDA MRI requirements.

Unfortunately, modern imaging technology is not always 100% reliable. NYC board-certified plastic surgeon Dr. Sophie Bartsich says, “In the last couple years I’ve had several patients who’ve had MRIs done because there was a question about their existing silicone gel implants. I’ve found that sometimes MRIs are not actually very reliable. In some instances, a patient’s MRI said the silicone gel implant had ruptured, and then when I went in to operate on it, it actually hadn’t. I’ve had one or two patients where an MRI showed the implant was not ruptured, but based on my clinical exam I really thought there was a concern, so I went in and it turned out it was ruptured.”

Some surgeons don’t even discover a silent rupture until they are switching out a patient’s breast implants due to aesthetic concerns or sizing changes.

Bottom line: if a woman waits until she is in pain or notices her breast is swollen, complications have already happened. At that point swapping out her implant is a much more extensive process and recovery afterward can be prolonged. 

What Breast Implant Revision Surgery is Like

If a silent rupture occurs with a silicone gel-filled implant, the majority of women want the ruptured silicone implant and sticky gel removed and replaced with something else. Sometimes it’s another silicone gel-filled implant, and other times women opt for a structured implant like the IDEAL IMPLANT®

“As far as breast implant revision goes, it is also a lot easier to replace a structured saline implant than a silicone gel implant, “ says California-based plastic surgeon Dr. Eric Bachelor. “When somebody has a ruptured silicone gel breast implant, especially the older implants which were liquid silicone gel, it is a very difficult replacement surgery. They may need a total periprosthetic capsulectomy or removal of the implant and reconstruction, which is a much more difficult procedure than swapping out a deflated saline implant.”

Remember that after any type of surgery, there’s a recovery process involved, where you have to avoid strenuous activity and exercise and halt a lot of your day-to-day activities. If you’ve already had a breast augmentation and been through the recovery process once, you might not be in a rush to do that all over again. In case of a rupture, women prefer that saline come into contact with their body tissues rather than silicone gel (91%). Dr. Bachelor says swapping out saline-filled implants is a much easier procedure, “Since it is filled with saline instead of silicone gel, replacing a saline implant requires just a slight revision and then a quick replacement of the implant.”

Why Do Doctors Still Push Silicone Gel Implants?

With all the knowledge we have about silent rupture, and the proof we have that women are very concerned about it, why do so many women continue to go into their plastic surgeon’s office and come out with silicone gel-filled implants? 

Many doctors push silicone gel-filled implants on their patients because silent rupture is not a problem for the doctor. They are not the ones with the implants in their bodies. They are not the ones keeping up with regular MRIs. They are not the ones having anxiety over silent rupture. In many ways using silicone gel-filled implants is easier for surgeons because they don’t deflate, so patients don’t know when they are ruptured. Other doctors simply have always used silicone gel implants and will continue to use them because they don’t experience the side effects of rupture firsthand. They’re not concerned about the possible health impacts from long term exposure to silicone gel. Silicone gel implants might look good and feel natural, but that’s not the end of the story.

Dr. Ting says, “Women have a right to have their concerns taken seriously about what is in their bodies, be educated about all of their implant choices . . . and not simply have their concerns dismissed.”

When you go in for a breast augmentation consultation, you may go into the office feeling like you know what you want, but then change your mind based on the plastic surgeon’s recommendations. With that medical degree hanging on the wall, it’s easy to feel like they have the expertise and should know best, and to keep quiet about your rupture concerns. Any plastic surgeon who is not willing to listen to what you want and who dismisses your personal preferences is not the doctor for you. If you experience this in a plastic surgeon’s office, it’s time to find a different surgeon.

Newer Options for Breast Augmentation

While some surgeons push silicone gel-filled implants on their patients because they personally prefer it, other surgeons may be unaware that there are other implant options out there that may alleviate their patients’ rupture concerns. 

Survey findings showed that 89% of women preferred an implant where a rupture could be detected by looking at the breast rather than requiring an MRI scan. With the new IDEAL IMPLANT, women can tell they have a rupture just by a quick glance in the mirror. They don’t have to worry about harmful substances coming into contact with their bodies because saline—which is salt water, like in your tears or an IV— is safely absorbed by your body.

The IDEAL IMPLANT significantly outperforms silicone gel for primary augmentation over ten years with both a lower risk of rupture and of capsular contracture. Only 3.7% of patients have the risk of rupture over ten years, compared with silicone gel implantsat 8.7-24.2%. 

The IDEAL IMPLANT also looks and feels natural, with an innovative design. A series of implant shells nested together and two separate chambers hold the saline filler. This unique internal structure gives the saline inside a more natural feel, while reducing folding and wrinkling. The edges of the implant have also been lowered for a more natural contouring to the chest wall.

Beauty Without Compromise

This is 2021, and you don’t need to compromise your safety to get the look you want. There’s no need to worry about silent rupture if you don’t want to. If you’re researching, “how old to get breast implants?”, take the time to research board-certified plastic surgeons, too. Your plastic surgeon should present all your options to you and let you make the final decision. Technology has advanced, make sure your surgeon has, too! 

You are your own best advocate, and you deserve to be heard. With the IDEAL IMPLANT, you get all the benefits of earlier implants, but without their compromises. The problem of silent rupture has been—put simply—solved.