This retrospective study evaluated aging and rupture of silicone gel breast implants in 31 women. The implants were removed at a large multispecialty clinic from 1987 to 1990. The implants ranged in age from 1 to 17 years. Of the 51 implants removed, 27 were ruptured, 7 were leaking, and 17 were in good condition. Common reasons for implant removal were discomfort, firmness, or a mass adjacent to a ruptured implant. Injury to the breast (trauma or mammography) led to a removal in only 4 patients. Closed capsulotomies were common in both ruptured and intact groups. The number of intact implants declined over time. All implants older than 10 years were leaking or ruptured. There was a positive correlation between the duration of implantation time and the number of ruptured and leaking implants.