Hi MJ, I had bilateral reconstructions with expanders and then silicone implants 18 months ago. The surgery to have the implants put in after the expanders is very easy and almost pain free. I haven't decided yet if I will have nipples created, or just 3D nipples tattooed, or if I will choose to do nothing. If I have the nipples made, the surgeon just does them as a procedure under local anaesthetic in his rooms. As far as replacement goes, my plastic surgeon has old me that there is no time line for that, and it is quite possible that they could last for 10 to 15 years, or more. These new implants are not as likely to rupture like the old ones, and provided there are no complications with contracture, they can stay put indefinitely. It is always a good idea to have an annual ultrasound to check that they haven't broken, but otherwise I am told to leave them alone. I have been given the anatomical shaped (tear drop) ones by Allergen, and they are quite comfortable. I haven't had any radiotherapy, which means I was a good candidate for implants. Hope this helps you a bit with your research. Good luck. Love Chris xx