Along with the improvement of breast implant surgery, majority of the women who have previously undergone breast implants will most definitely want to know, or will worry how about how long can the bag that the surgeon inserted in to their body last? Will it leak or break? Or under what circumstances can leaking occur? Actually, the assumption of these questions will probably not happen, and this is also why surgeons find it hard to give a definite answer regarding the safety of the implant materials. However, does this mean that consumers who have had breast implants before can only depend on their luck and fortune?

In order to discuss this solemn topic, we need to understand the fundamental structure of saline water bags and other implant materials. Firstly, when the surgeon opens the sealed aseptic packaging, a hollow bladder shaped object and another thin tube for filling water can be seen. This is the condition when saline water bags have not been filled with water. The surgeon will then insert the thin water filling tube on to the water filling hole of the bag. After that, air will be extracted and then the bag will be inserted into the patient’s body. After confirming that the bag is in position, water will be filled. When water is filled to the standard capacity, the water filling tube can be removed. At this moment, the one-way valve of the bag’s water filling hole will seal up hermetically, thus water will not be able to leak out. At the same time, this also ensures the long term use rate of salt water bags. As for the use of silicon gel, which is currently not officially approved by Taiwan’s government, is an all in one type of filling. There are no procedures such as filling water by the surgeon required. Therefore the percentage of leakage is even lower. Here we will not discuss it any further.

After understating the structure of the bag inserted into the body, next, we can discuss the possible circumstances which may cause the saline water bag to leak. I have roughly categorized them into the following points.

1.Faulty quality of material itself:
The rate of this issue occurring is the highest. Normally, leakage will easily occur at the weak point of the one way valve. Due to low quality of the bag, after long term usage it will be unable to seal water inside. This kind of problem rarely happens to saline water bags produced by well known qualified manufactures. Unless it is a faulty product, otherwise it is almost impossible for leakage to happen. Apart from this, leakage may also happen at the pressure point. This situation occurs at the site of capsular contracture. Due to the constant rubbing of the bag with capsular contracture, it will become thinner and weaker, eventually causing a crack. The occurrence of this situation will vary on each individual; it cannot be simply prevented by using bags produced by well known manufactures.

2.Surgeon’s inobservance during surgery:
Surgeons must also be very cautious with the procedure for installing saline water bags. During training, every cosmetic plastic surgeon will be repeatedly reminded of this issue. If surgeons, when installing the tube used to fill the water, repeatedly inserts or use tweezers and other tools to clip or push the saline water bag (this is unpreventable during belly button procedures) or applying inappropriate force when removing the water filling tube, all have the possibility to cause the bag to leak in after long term use. Consequently, in order to prevent these possibilities, surgeons must be extremely careful when installing the bag.

3.Improper use by patient:
Once the bag has been implanted into the patient’s body, the condition of use will vary greatly depending on each individual. Especially, the constant contact and rubbing of the bag with the body, excessive pushing and squeezing can cause the bag to break or reduce the life span of the bag. These issues have all been overlooked by everybody. There have been instances where the patient was massaging her breasts after surgery and broke the implants, or during acupuncture, the implants where poked and it broke, there are all sorts examples of improper usage.

4.Severe external force or impact:
This is when accidents occur. For example, car crashes, when airbags go off, or falling from high places, serious accidents and so on, causing multiple bone injuries, then there is the possibility that the saline water bag will break. However, these are purely problems of human errors chance of occurrence; consumers can only try to prevent them.

Due to the unpredictability of point 3 and 4 described above, patients can only take care by themselves. However, if the problem is on the material of the bag it self or its quality, then how can consumers notice and beware of these problems? Especially, most of the leakage occurs gradually and not instantly or can be felt obviously. What if after eight years of surgery, one finds out that their implants are slowly shrinking in size, what happens then? Should we worry and spend more money again?

In Japan, due to increased consumer rights awareness and the consolidation of post surgery services, there are many surgeons offering warranty on the material of breast implants. Although the contents of the warranty maybe different from surgeons to surgeons, but from a consumers perspective it is another advantage, offering more protection to consumers. This kind of post surgery service not only reinforces the trust between surgeons and patients but allows patients no longer have to worry about their implants. From this, I have also started to provide these kinds of post surgery services in my clinic, to allow patients not have to face the concern of the quality of the water bags, can enjoy more happily what they have worked hard for.

Currently, the warranty is provided by the clinic, not the manufactures. This means that even after ten years of the implant, if the water bag is natural leakage and not caused by external forces, then patients do not have to bare the cost for the water bag material which could cost tens of thousands of dollars. Even if there is a problem with the bag within one year of surgery, you do not need to spend an extra cent; we will replace the bag for you at no extra charge. If the leakage occurs after one year of surgery, then consumer only need to bare the cost for anesthesia which is minimal, the bag is still free. This warranty service not only allow you to obtain the original certificate from the salt water manufacturer, the clinic will also provide a certificate explaining the brand of implant material used, its capacity and warranty explanations for you to take home to keep for later reference.

An old saying said it is easy to sale, but after sale service is hard. This refers to many unknown circumstances that are hard to prevent or overcome in the future. However, for most of the products that we can see offered a warranty for a certain period after purchase, needless to say, about the water bag that is going to implant into our body. We should not discuss whether this unfortunate matter would happen to ourselves. However, spending some money to purchase a guarantee security will be a trend in the future. At least I think the clinic or hospital, that can provide this kind of guarantee to patients must be able to provide the following services:

I. Saline water bag must be chosen from well-known manufactures in order to reduce the possibilities of faulty materials.
II. Surgeon must be extremely careful during surgery to prevent any human errors.
III. Surgeons and nurses must continuously educate patients about the correct concept and hygienic education in order to reduce the chances of impropriate usage to the minimum level.

Above are the guarantees that will best benefit the customers; after the surgery you can massage it without any concerns, and consumers can be in harmony with their implant. Also there is no need to worry about breakage or leakage problems every minute. This is the original purpose of breast implant in first place!