Like all man made products, breast implants do not last forever. Despite being very robust and resistant to even extreme pressures, they are susceptible to daily wear and tear over time. What this means in simple terms is that the outer shell or coating of the implant eventually wears thin and ultimately disappears. If this happens then the contents of the implant leak out. This is usually termed disintegration, leakage or rupture of the implant. Clinically however this may be difficult to spot. Occasionally one may detect a slight flattening of the breast or an alteration of the shape, but this may only be very slight and hardly noticeable. Sometimes if there is a large amount of leaked silicone then large lumps may occur in the form of swollen lymph glands. These are described as granulomas and are associated with implant ruptures. Capsule formation (see below) is the main reason that ruptures of an implant can sometimes be tricky to detect. Concurrently, capsule formation can also occasionally be the result of a rupture. As previously stated, a capsule forms a type of “biological bag” encompassing any breast implant. Should leakage of the implant therefore occur, the contents will still be contained in the same location by the body’s own bag or capsule. Despite being difficult to detect clinically however, thankfully an ultrasound scan will most times be able to accurately assess the condition of any implant when necessary. Another entity to be aware of is Gel Diffusion. Gel Diffusion occurs from minute quantities of silicone which diffuse through the implant shell. This is different from granulomas described above and is usually clinically insignificant. Moreover, with advances in implant technology and shell design, gel diffusion has been drastically reduced. There are many quoted figures as to how long ultimately any implant lasts before disintegrating. An average figure for modern breast implants is probably in the order of 15- 20 years. There are however variations in the wear and tear amongst different individuals. A women therefore who subjects herself to extreme physical exercise for many hours a day on a regular basis with resultant excessive movements of her breasts (i.e. aerobics instructor, marathon runner, regular horse riding etc.) will naturally subject her implants to more wear and tear over a given period of time, than someone who does very little exercise. In the first situation it would be reasonable to assume that the implants may disintegrate sooner than in the latter case. Indeed there is such variability at times, that Mr. Solomos has encountered patients requiring change of implants as early as 2-3 years (very rare) as well as patients needing changing at 40 years! In order therefore to have a proper assessment of the state of your implants it is best advised to have your implants examined by a specialist on a regular basis from about 10-15 years after your operation and an ultrasound or MRI performed as necessary.