An informed decision begins with honest information.

No. Breast implants do not have a fixed expiry date and do not automatically need to be replaced simply because ten years have passed.

If the implants are unchanged and there are no symptoms, implant replacement solely because of their age is not necessarily required. At the same time, it is not possible to predict whether they will remain unchanged for life.

Long-term follow-up and the possibility of further surgery should therefore be part of the decision from the outset.

A lifetime warranty does not usually mean that the implant itself is certain to last for life.

Depending on the manufacturer’s actual terms, a warranty may provide a replacement implant in certain recognised product situations. It may concern the product only and may not cover surgeon, hospital or anaesthetic costs.

A warranty relating to possible product replacement is therefore not the same as lifetime durability of the implant.

Further surgery after breast augmentation with implants is not unusual over the long term.

Reasons can include capsular contracture, changes in shape or position, implant damage, symptoms, or a later wish for a different size or for implant removal.

The likelihood of complications and further surgery increases over time, but the timing and reason cannot be predicted for an individual woman.

Breast implants should be followed over the long term, even when there are no symptoms.

Which examinations are appropriate, and when, depends on the implant type, implant information, symptoms and the individual medical situation. Medical examination, ultrasound or an MRI scan may be considered depending on the circumstances.

New pain, firmness, swelling, a lump or an unusual change in the breast should be assessed promptly rather than waiting for a routine appointment.

Yes. Damage to a silicone breast implant can sometimes be silent, without pain or an obvious change in the breast.

For silent silicone implant rupture, an MRI scan is the most effective imaging method. Ultrasound may be an acceptable alternative in some circumstances.

The right examination depends on symptoms, implant details and medical advice.

New firmness or a change in breast shape can be caused by capsular contracture, but other causes are also possible.

Capsular contracture occurs when the connective-tissue capsule around an implant thickens or contracts. This can make the breast feel firm, change its shape or position, and sometimes cause discomfort or pain.

A newly firm, painful, swollen or changing breast should be examined so that the cause can be identified and the need for treatment assessed.

Yes. The breast, tissue envelope and implants can all change over time.

Implants may alter position, become palpable beneath the skin or develop visible rippling or wrinkling. Asymmetry, discomfort and changes in breast or nipple sensation may also occur.

Not every change requires further surgery, but the finding should guide whether follow-up, imaging or correction is appropriate.

A new one-sided swelling, persistent pain, marked firmness, a lump, a new fluid collection developing years after surgery, skin change or unusual change in breast shape or size should be assessed medically.

These changes can have different causes, many of which are treatable. Because they can also occasionally point to rare implant-associated conditions, they should not be ignored.

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare lymphoma of the immune system, specifically a T-cell, non-Hodgkin lymphoma.

It is not conventional breast cancer. It usually develops in fluid or capsule tissue around a breast implant rather than in the breast tissue itself.

Warning signs may include persistent swelling, a new fluid collection developing years after surgery, a mass, pain or new hardening, often years after implantation. These symptoms should be assessed promptly.

BIA-ALCL is rare.

Risk is not the same for every implant surface. It is higher with textured implant surfaces than with smooth surfaces.

An individual risk estimate cannot be reduced to one general number and should be discussed in the context of the implant history.

Squamous cell carcinoma in the capsule around a breast implant is a very rare malignancy reported in the tissue capsule surrounding an implant. It is sometimes referred to as breast implant-associated squamous cell carcinoma or BIA-SCC.

It is distinct from BIA-ALCL and is not the same as ordinary breast cancer arising in breast tissue.

Cause, incidence and risk factors remain uncertain. Reported symptoms have included swelling, pain, a lump or skin change, and such symptoms require medical assessment.

Routine preventive removal is not generally recommended in symptom-free women solely because of concern about BIA-ALCL or capsule-associated SCC.

Long-term awareness remains important, and new swelling, pain, a mass, a new fluid collection developing years after surgery or other unusual changes should be assessed medically.

Personal implant history, previous symptoms and individual circumstances may still justify a specific medical discussion.

Breast Implant Illness, or BII, is a term used for a range of systemic symptoms reported by some women with breast implants.

Reported symptoms may include fatigue, problems with concentration or memory, joint or muscle pain, anxiety, hair loss or other health concerns. These symptoms can be very distressing and should be taken seriously.

There is currently no single recognised disease process that explains all cases, and a causal relationship with implants has not been conclusively established. Some women report improvement after implant removal, but this cannot be promised.

New symptoms should be assessed medically, and other possible causes should be considered rather than automatically attributing every symptom to implants.

Yes. Routine breast screening can remain important with breast implants.

The imaging facility should be told in advance that implants are present. Trained staff can use appropriate techniques for mammography in women with implants.

Mammography is used for breast screening and assessment of breast tissue. It is not the primary test for silent silicone implant rupture; for that question, an MRI scan is the most effective imaging method and ultrasound may be acceptable in some circumstances.