I don't think it is a great idea to have silicone in the body, but since you haven't experienced any problems with your implants in the 13 years that you've had them, I see no reason to undergo the trauma and expense of surgery to have them removed. Some 1.5 million women in the United States have had silicone breast implants, and as you know, some of them have developed serious medical problems, including a variety of autoimmune reactions. Medical evidence has shown that these diseases (and others including cancer and neurological disorders) are no more common among women with breast implants than among those without implants, so a cause-and-effect relationship is not clear.
However, these diseases aren't the only potential problems related to silicone implants. They also can develop leaks, and it has been estimated that up to six percent of them rupture. It is important to take notice of any changes in the breast that could be related to implant damage. Similarly, I would urge you to be alert to any symptoms of autoimmune diseases, such as joint pain, unexplained fever, rashes, or neurological problems.
Another factor to consider is the cost of having your implants removed. If you had the implants put in as a cosmetic breast augmentation procedure, I doubt that the cost was covered by your health insurance. The same will probably apply to their removal. Insurance carriers are unlikely to pay for the procedure unless the surgery is medically necessary and the implants were part of breast reconstruction following a mastectomy.
Andrew Weil, M.D.