At this time, there are three major manufacturers of breast implants in the United States, Allergan, Mentor and Sientra. All of them offer a lifetime warranty against deflation of their implants in the form of providing a free replacement implant. In addition to providing a free implant, each company also offers up to $1200 to cover the costs of surgery, anesthesia and facility to replace a saline implant and as much as $3500 for a silicone prosthesis if the deflation occurs within ten years of the original implant surgery. The saline warranty can be upgraded to match that of the silicone warranty for a fee of about $100 and must be purchased within about six weeks of surgery for Allergan and Mentor; Sientra only makes silicone implants.
Breast Implant Replacement
Replacement of a ruptured saline implant can often be done in an office operating room using local anesthesia along with mild oral sedation unless they are being replaced with larger implants or significant time has passed where the implant pocket has been allowed to close; in these cases, the pocket must be widely opened to accommodate a new implant. Recovery from replacement of a deflated breast implant is typically much easier than the original procedure for breast augmentation because the implant pocket already exists. Even in cases where the pocket must be enlarged, there is typically very little pain when replacing a deflated implant.
Frequently, patients who suffer from a deflated implant and, therefore, require surgery for replacement will take that opportunity to change to silicone implants or change the size of their implants. With the purchase of the expanded warranty with saline implants, patients can generally receive discounted rates for the purchase of silicone implants in the event that they suffer from a deflated saline implant in the first ten years.
Cause of Rupture
Implant deflation is usually not due to any form of trauma or something done wrong by the patient. Scar tissue which forms around all breast implants can cause a slight fold in the implant shell which creates stress on the wall and can eventually result in a loss of the integrity of the implant. The risk of implant rupture is about 1-2% per implant per year after insertion. Fear of rupture of an implant because it has been in place for many years is not a good reason for implant replacement. There is no specific time frame which dictates when a breast implant needs to be replaced. The most common reason for reoperation is for repositioning of and implant that has moved out of the original intended implant pocket or to change the size of the implant.
There does not seem to be a significant difference in the incidence of rupture of silicone compared to saline implants, however, there is evidence to show that textured saline implants have a higher risk of deflation compared to smooth walled saline implants. This is one reason why most plastic surgeons use smooth walled implants for breast augmentation.