That is pretty much it
Plus the fact that now these super big size woman, Mary Madison for example are using tissue expanders as Permanent implants as well as filling them FAR beyond there rated capacity.
This was not the case back when Tiffany needed her replacement implant/s.
Tissue expander implants did exist back them but they were only "temporary"
Basically a girl that was really small, A or B cup small, Wendy Whoppers for example who wanted to get really big, an end goal of 3000 CC which were about the biggest silicone implants you could get had 2 options. Get 4 or 5 sets of implants, going up a max of 2 or 3 cups sizes at a time, a new set every 6 to 18 months depending on how they healed up and "settled in" , each time risking complications, infections, not waking up from the anesthesia to say nothing of paying from 5 to 15 K a pop or start with tissue expanders and add saline every other month or so the way the women today do until they got to about 2500 CC which was what they were rated for and get there in around 18 months and from there a PS who specialized in big implants like Dr. Gerald Johnson in Houston could remove them and squeeze in a set of 3000's
No PS at the time would put them in as permanent implants because the CW was that the shells would fail after a few years so they were only in 2 or 3 years max and none would go to overfilling them like is the norm now
Plus almost all Dr.s would rather get paid to do 4 or 5 boob jobs rather than just 2 with a few office visits for saline fills at a few hundred bucks a time so few Dr.s at the time, the time she would have needed at least one of them to replace her ruptured implant would put them in in the first place