What you should know about breast implants after 40

With childbearing behind them and menopause approaching, more women older than 40 are choosing to have breast augmentations. Perhaps they want to turn back the clock as they begin to see the effects of aging, while younger women also continue to have interest in breast augmentation — but for different reasons.

Plastic surgeon Andrea Moreira, MD, says, “We see both young women who have not yet had children and women who have already had their children come in for breast augmentation. But these two age groups often have different reasons for wanting the surgery and different goals.”

What women want from breast augmentation

Dr. Moreira says that the younger women, age 20 to 23, are more likely to have more severe breast hypoplasia. In other words, they usually have very small breasts when they come to see her at this age and they hope to attain a fuller, more shapely look, while still appearing natural.

The older women Dr. Moreira sees typically voice concerns about age-related changes to breast appearance. Aging causes a loss of volume and breast tissue begins to sag, she says, making women look older than they feel.

“Many women are waiting until later to start their families. Once they’ve had their children, they’re older than women in the past who finished having babies by their early 30s. This may contribute to this trend of older women choosing to have the procedure,” explains Dr. Moreira.

She says that while there’s nothing wrong with getting breast implants before you have children, breastfeeding is always a concern. Most women can breastfeed after having implants, but depending on a number of factors, a minority of women cannot successfully nurse after having the surgery. Women who have finished childbearing don’t have to consider this possibility.

Concerns about mammograms with breast implants

“Many women over 40 worry if getting breast implants will interfere with having mammograms. In terms of mammograms and imaging over time, breast augmentation tends to be quite safe,” Dr. Moreira says, adding that most of the time plastic surgeons place the implants under the muscle, which puts them in a separate space from the breast gland.

Women should always let their mammography technician know they have breast implants before the imaging process starts, she says. The technician will then use special techniques when taking images of the breasts so the implants don’t interfere with the radiologist’s ability to detect any problems.

Sometimes women fear that the squeezing from the mammography device could rupture or displace their implants, causing a need for corrective surgery. “Implants should not rupture or become displaced with a mammogram. I know that they’re squeezed in different shapes during the process, but an implant that is intact should not have an issue,” says Dr. Moreira.

However, implants usually have a shelf life. They’re very good for the first 10 years, but after that doctors tend to monitor them a bit more closely. As an implant gets older, the outer shell loses strength and can leak. When the integrity of the outer shell deteriorates, the implant is more easily broken.

She says, for example, if a woman received her implants 25 years ago and now goes in for a mammogram, the possibility of rupture increases. Even so, Dr. Moreira says ruptures are still very rare.

Older women may need breast lift as well

Women older than 40 tend to have more realistic expectations about what breast augmentation can do for them and why they want the surgery in the first place. According to Dr. Moreira, the primary concern with this age group is that some of these women may have a loss of volume with a lot of excess skin on the breast due to childbirth or weight loss. The surgeon needs to evaluate whether this excess skin will interfere with the aesthetics of the implant.

If enough excess skin exists to detract from the look of the augmentation, the woman may need to have a breast lift at the same time as the breast augmentation procedure. However, a breast lift will leave more noticeable scars than a breast augmentation. Women need to understand this before agreeing to the procedure, says Dr. Moreira.

Despite any concerns, it’s really no big mystery as to why more women older than 40 are choosing to have breast augmentations. Dr. Moreira says that older women are typically more self-assured about their place in life and are often more financially secure than many younger women, which likely contributes to this growing trend.

“Women past childbearing age have no intention of spending their later years feeling frustrated by their bodies and most report high levels of satisfaction after undergoing breast augmentation surgery,” she says.

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