Just like everyone who had breast augmentation, their implants will age with time. That being said, the degree to which this occurs varies from patient to patient. Patients will have different starting points when they choose to undergo a breast augmentation procedure with respect to both breast volume and skin quality. These factors, together with the patient’s skin quality, smoking habits and most importantly, DNA have an effect on the strength of the skin.
How your breast size affects your implants as it ages
Small breasted women in the A to B cup range – the highest percentage of women who had this procedure – often have the best chance of a long-lasting result. This is because their skin is less lax and have a tighter fit to the breast itself, which gives a less additional weight on the tissue that ages with time. The breast and implant are also more closely fitted, thus maintaining a more singular aging unit. And with pregnancy, there is less breast tissue to change that gives less stress on the skin.
The only negative issue with a smaller breast size is that the patient will likely show more of the implant through their tissues since there is less soft tissue coverage.
On the one hand, women with slightly larger breasts will have a softer and more natural outcome since they have more soft tissues to help cover the underlying implants. These patients also often have some additional excess skin that accommodates the implant better than women with smaller and tighter starting points. Frequently, the implants remain in place underneath the original breast position tightly held in the breast capsule, but the actual breast tissues eventually age in the implant.
Changes in the breast and implants and how it is corrected
This leads to a circumstance where the implant is out of balance with the actual breast tissue. Depending upon the age of the implant, this can frequently be corrected with a breast lift or “Mastopexy” alone where the breast is repositioned to balance with the implant.
Normally, this also occurs after pregnancy and breastfeeding. The rapid and significant change in the breast skin often results in skin stretch and ultimately stretch marks commonly termed striae. This contributes to the aging of the breast skin resulting in post-partum droop or ptosis. If there is limited skin droop, there can also be a decrease in the strength of the skin that eventually allows the implant to descend more than desired. Some women are fortunate and have little changes to the breast, but most will be left with excess skin and less breast tissue than they started.
A breast lift corrects this phenomenon well by re-balancing the breast tissue with the underlying implant. The amount of lift and scar needed is dependent on the patient. If the patient desires a change in the implant size or shape, then an implant exchange can easily be combined with the lifting procedure. Frequently, patients are at different stages in their lives and desire a different “look” than earlier in their lives.
Finally, patients can have something termed “implant malposition” where the implant is placed improperly or gradually migrates over time due to forces from the patient’s body. This can also occur as a result of too large or too small implant. Implants can end up in less aesthetically pleasing locations and surgery can help to modify the breast pocket – where the implant resides – to help center the implant in the proper location. This is usually the combination of both capsule tightening and releasing which occur at the deeper level with no visible scars.
You and your implants
Although nothing lasts forever, breast implants are warrantied for life. All implant manufacturers in the United States (Allergan, Mentor, and Sientra) offer patients an additional money toward a replacement surgery if a rupture occurs in the first 10 years – aside from the free implants! They strive to provide patients with excellent support over their lifetime, which gives most patients significant confidence in their decision.
It is important to remember that breast implant surgery is an excellent decision for most women, but the procedure, unfortunately, does not stop you from aging or the effects of time. Weight loss or gain, pregnancy, and your DNA all have a significant impact on the life of your results. Thus, there may be another surgery in your future if you decided to undergo breast augmentation, but the vast majority of these are for normal cosmetic changes that would occur with or without breast implant surgery.
About the author: Dr. Vincent P. Marin is a board-certified plastic surgeon who offers first-rate services at La Jolla and San Diego. He is a graduate of Harvard University and the Columbia University of Physicians and Surgeons. Dr. Marin provides his patients with the highest level of skill and artistry, using state-of-the-art technology to deliver safe and beautiful results.