Breast implants are not a lifetime procedure—as the nation’s most prevalent plastic surgery, they are an aesthetic alteration that requires maintenance. Studies show and the FDA stresses that nearly one third of women with breast implants have at least one additional surgery in the first ten years, making it even more essential to understand the potential complications associated with the procedure.

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A Decade Under Warranty

Unfortunately, there is not a medical consensus to define the lifecycle of an implant; some women have had implants for 40 years with no problems, while others are on their fourth set.

However, manufacturers suggest that women can expect a decade’s worth of mileage before they see any issues.

Both Mentor and Allergan, (maker of Natrelle implants), offer limited ten-year warranties by default. The warranties cover replacement implants and put $1,200 towards reoperation fees. Each also offers premium warranties for an additional $100 that cover up to $2400 of surgical expenses. By comparison, replacement surgeries cost anywhere between $5,000 and $10,000.

Warranty Shortcomings

Even if the implants are still under warranty, complications can warrant hefty out-of-pocket fees. Insurance does not cover MRI examinations (the only way to detect silicone leakage), and rarely covers additional reoperation costs. Plus, none of the policies compensate for lost time or any travel expenses associated with reoperation (for women who had operations done in a different state, for example).

Furthermore, patients may require additional surgery not only due to a defect, but on account of complications like shifting, capsular contracture or internal scarring.

Be Prepared

The warranty only lasts a decade, but the longer the implants are there, the more likely they are to break or leak. If this occurs, they will need to be removed and replaced.

Dr. Linda Huang, a plastic surgeon in Denver, says that women must expect to spend at least as much on maintenance as on the first surgery. “If they would rather spend their money on a trip to Paris…then I recommend they do not have breast augmentation to begin with,” she told the New York Times.

Don’t Dismay

Even though over 20 percent of women needed follow-up surgery, roughly 90 percent report satisfaction with their implants. Understanding beforehand that additional surgery will likely be needed, whether in the first ten years or further down the line, will help many to take complications in stride and remain happy with their implants.