When a woman opts to undergo breast augmentation, she is committing (most likely) to maintenance surgery down the road, as breast implants are not lifetime devices.

Now I have seen breast implants that have been in place for 35 years.  And I have seen deflations in a short period of time.  So it is hard to know how long an individual breast implant is going to last.  We look to the published data for guidance, but it is hard to get long-term data until a long period of time has passed, and if they improve or change the implant, then the old data may or may not apply.  And remember that data such as failure rates apply to large populations of implants, but that in an individual woman, the actual time will vary.

So when should a woman revise her implants?  Well, after surgery they will evolve for a period of months.  So it will take a little time to get the “final” product (as final as possible given that your breasts will continue to evolve as you age).  But if something seems off in the short term, I would wait at least 3-6 months before I consider revision surgery, depending on the nature of the problem.

As far as the long term, the basic answer is I would revise them when the patient wants them revised.  Sometimes we get calls about a set of implants that is approaching 10 years old.  There is an urban legend that implants need to be revised at 10 years–if they are doing well, I would leave them alone.

The only caveat is that if the implants are silicone and are ruptured, I would recommend removal with or without replacement.  The new FDA guidelines ask for MRI’s 3 years after surgery and then every 2 years to look for silent rupture.

And with a revision, discuss with your doctor if you need a plance change, or a change in type of implant.  Every patient is different and has different goals!