Janie,
A little background on me before I comment. I've had implants for 24 years now. I've had 3 sets in my lifetime (2 silicone filled, one saline). I've never experienced any health related/and or implant related complications(cc, rupture). I've had them replaced for maintenance. I guess you could say I've been pro-active in that I've never waited for a rupture or for my implants to outlive their shelf life(whatever that is). Silicone can have silent ruptures that go years undetected. Saline ruptures are obvious. I currently have silicone that are about 5 years old.
I initially got them because my breast deflated after the birth of my first child. I was not unhappy with my size. I was unhappy with the shape and sag of my breast. It was as though my breast tissue had been scooped out and I had two empty socks hanging.
Now that I'm approaching my 46 birthday, I've outgrown the size of my implants. I wish I had my old size B breast back. I've researched having my implants removed and found a website called explantation.com. Reading that website is frightening on many levels. There are horror stories from women who say implants made them ill. I have to mention this, because reading those forums puts fear inside you. I personally will not make a fear based decision because I've had implants so long and have my health.
Many women regain normal looking breast after explanting, and some do not. Some look rather empty, and some form adhesive scars which make the tissue stick to the chest wall in an unusual manner.
One thing I know for certain...you will need an experienced surgeon to do it. Some surgeons will try to steer you away from explanting.
Look for a surgeon who devotes a lot of time to breast reconstruction. If the surgeon doesn't have a lot of reconstruction experience, you stand a pretty good chance of looking empty or worse, deformed breast.
It's a shame. The PS's never discuss this when they talk to you about implanting.
Have you had the same set for 33 years? Are they silicone? If so, you may have a rupture and will need silicone clean up. Not trying to frighten you, but you need to know how important it is to find a qualified explant surgeon.
explantation.com has a forum with photos etc.
As for me. I've given it a lot of thought and I've decided to reduce the size of my implants by more than half and switch to saline. I'm just not ready for complete removal. This will be my last set. I decided to do the step down approach