Like most things created in the modern age, medical and surgical implants such as dental implants or hip replacements have a commercial ‘best by’ date. Whether it is a medical implant to replace or support a body part such as a heart valve or hip replacement or whether it’s a cosmetic implant such as a breast enhancement it is important to understand what the useful life of a particular implant might be when making your choice and also the importance of selecting the right professional to do the work!
The ‘useful life’ of the implant may include issues such as the manufacturer’s warranty period for the implant, the implications of your lifestyle on your choice of implant (a ceramic hip may not be a good choice for an active person) and the type of implant (material) that you choose. This information is something to be mindful of when researching options and selecting the most appropriate implant for your particular circumstances. It also very important to know if or when you may have to remove/replace these items.
Average Useful Life of Common Implants
Average life expectancy for common implants (please remember that these are averages. There are different types of implants in each category below, and depending on the type, the material and your personal circumstances, your particular implant will have a different life expectancy)
- Pacemakers: Battery replacements are required approximately every 8 years but more often if you have a bi-ventricular pacemaker with a defibrillator.
- Dentures: 5-10 years.
- Titanium Dental implants: should have a minimum 10-year life expectancy, while one study showed a 17-year life expectancy
- Crowns: 10-year average for crowns on teeth or dental implants.
- Breast implants: The U.S. Food & Drug Administration (FDA) estimates that 1 in 5 women may need to have their breast implants replaced within 8 to 10 years. These days, the major manufacturers of breast implants will often offer a lifetime warranty on the actual implant device but after ten years the costs associated with having surgery to replace the implants are no longer covered. One study showed a mean of 5.6 and 12 years after insertion of saline and silicone implants respectively before rupture of some sort.
- Hip replacements: Today, a hip replacement is expected to last ~20 years. Note that inDecember 2017 the U.S. Food & Drug Administration issued a note about Metal-on-Metal hip implants that you should review if you have previously had a Metal-on-Metal hip implant.
Surgical Implant Check List
Any surgical procedure has inherent risks. The most common surgical risks are associated with infection, anesthetics or haemorrhage and of course each particular implant is likely to have its’ own unique risks.
With any medical or cosmetic implant that you are considering, there are a several critical items that you need to tick off your check list before committing to the procedure:
- Understand the details about what options there are for the type of implant that you require and what the differences are between the different options. For example, patients requiring a replacement heart valve will typically be offered the choice of a carbon-based mechanical valve or a tissue valve. Look at the benefits of each option and in some countries you will find that ‘revision’ statistics are available for some procedures where certain implants, as in the case of total hip replacements, are known to be linked to higher rates of revision surgery.
- Make sure that you clearly understand the future implications of the management and/or replacement of your implants. For example if you are a smoker considering dental implants then the failure rate for your dental implants may be almost 15 times higher than for a non-smoker and you are at a greater risk of post-surgical infection. For breast implants, Magnetic Resonance Imaging (MRI) is recommended by the FDA 3 years after implantation and then every 2 years after that to screen for rupture.
- You might have selected the best quality and most appropriate type of implant, but if the surgeon who will conduct the procedure isn’t appropriately credentialed then you are probably heading towards a bad outcome. ‘Appropriately credentialed’ firstly means holding a current licence and qualification in the surgical speciality (check out our blog ‘When is your ‘surgeon’ not a Surgeon’ ) relevant to your operation. Secondly it means that in addition to holding recognised surgical qualifications, your surgeon should have experience in the procedure you are considering and a lower than average rate of complications resulting from the specific surgery you are seeking. To emphasise the importance of your surgeon in a very practical way:
A 2016 study led by researchers at Stanford University found that 1% of practicing physicians accounted for 32 percent of paid malpractice claims
- You should always ask your surgeon the reasons why they are recommending a particular type and brand of implant to you. Whilst unlikely, it is important to know if the surgeon is receiving or has ever received any type of financial payment from the manufacturer. Please note that payments are not necessarily evil (read this article relating to payments by pharmaceutical companies to doctors) and different countries have different laws regarding the legality of payments. Transparency is the key issue for you as a patient and you have a right to know if there is any relationship between your surgeon and the manufacturer of the implant being recommended to you.
The Bottom Line
So, it is safe to say that if you are planning to undergo a procedure for a surgical implant of any type then there is plenty of homework to do beforehand! Any surgery carries with it risks and you owe it to yourself to do all you can to minimise the risks by conducting the appropriate research on implant options, hospitals, clinics and surgeon’s that will be carrying out your procedures (don’t forget somewhere safe and appropriate to recover).
With regards to cost, there is no reason to sacrifice quality for what may appear to be a cheaper option. Clearly, if you are satisfied with the quality of healthcare in your home country and your health insurance will cover your procedure with little or no gap/out-of-pocket-expenses/deductibles (the difference between what the total cost of the procedure is and what your health fund will pay) then cost should not be the primary driver for your choice and finding a local surgeon is probably the right option for you.
If however your health insurance will not cover the procedure or your gap/out-of-pockets/deductibles are likely to be substantial, then you should not limit your search by geographic boundaries. Quality, not borders or cost, should be the key factors in your decision. With the information available to you from providers such as Ticadoc, you can find quality surgeons, hospitals and hotels delivering best practice healthcare services in many different countries around the world.
Seek quality at the right price rather than cheap prices and random outcomes. Remember, if it appears too good to be true, it probably is.