Category: Breast Implant Rupture

Approximately 3.5 million people in the United States have breast implants. Often placed for cosmetic purposes, implants are positioned either above or below the pectoralis muscle. Implants can be saline or silicone. A possible complication of breast augmentation is implant rupture or leakage. The question often asked is whether a leaking implant must be removed.

Saline or Silicone?

The first issue to determine when answering this question, is whether the implant is saline or silicone. All implants will have a fibrous capsule that develops around them, which is called the capsule. It is the human body’s reaction to a foreign body. Implant rupture that is contained within the capsule is referred to as an intracapsular rupture. If the leakage extravasates outside the capsule, then it is referred to as extracapsular leakage.

Saline Implants

If a saline implant leaks, the saline solution is harmless and becomes absorbed by the body. The shell of the implant remains though. Although not necessarily dangerous, the collapsed implant can become uncomfortable if the edges press against the overlying skin. A ruptured saline implant will always be intracapsular as the saline solution is absorbed. The sign of a ruptured saline implant is deflation of the breast resulting in it looking smaller and more wrinkled compared to the breast within an intact implant.

Silicone Implants

When evaluating a leaking silicone implant, it is important to determine whether the rupture is intracapsular or extracapsular. An intracapsular leakage can form capsular contracture which is where the fibrous capsule around the implant becomes thicker and harder. This makes the implant feel very firm and unnatural. Capsular contracture can also cause implant malposition, shifting the implant to an unnatural superior position within the breast. Breast asymmetry then occurs. Extracapsular leakage has the added complication of silicone gel leaking into the breast tissue. This causes scar tissue to form in the breast and manifests as a breast lump. Older silicone implants are less cohesive than newer ones and tend to have more extravasation. Silicone from a leaking implant can also travel to the lymph nodes.  Therefore, removing a ruptured silicone implant is important and should be done if the operation is safe for the patient. Obtaining mammograms with a leaking implant can be more difficult due to capsular contracture which causes firmness. Also, the compression during mammography can cause further extravasation of an already leaking implant.

Get A Consultation

The best thing a woman can do if she suspects or wonders whether her breast implants are leaking is to consult with a board-certified plastic surgeon. The appropriate testing can then be obtained to determine whether removal should be performed.

Every kind of breast implant is constructed with an outer shell made from silicone. The silicone can develop a hole or tear, which is called a rupture. As time goes on, the chances of your implants leaking or rupturing becomes higher. What do you do if an implant ruptures?

Recognizing a Ruptured Breast Implant

There are a surprising number of circumstances that can cause an implant to rupture. Ruptures aren’t always caused by a hard impact or trauma. As the implant ages, it naturally becomes less sturdy and more susceptible to rupturing. At that point, any number of things can cause damage. You might experience trauma in a car accident, have a needle inserted through the implant during a biopsy, or have a rupture caused by damage to the implant caused during the first surgery.

Saline Ruptures

Saline and silicone ruptures are different in their presentation. Saline ruptures and leaks can occur due to damage or a failing valve. The leak causes the saline to exit the implant over a few days, which then leads the breast to appear deflated. The deflated appearance immediately indicates that it’s ruptured. Because the body absorbs the saltwater, there aren’t immediate consequences from the leak itself.

Silicone Ruptures

A silicone rupture involves gel instead of liquid saline. Since the gel solution is thicker, it leaks much more slowly. Some people don’t notice their silicone implants have ruptured for a while because they don’t cause the same rapid deflation as a saline rupture. The body is not capable of absorbing silicone gel.

The signs might be more subtle than an obvious deflation. Your breasts might gradually change in size and shape. You might also experience tenderness that escalates into increasing pain, swelling, and firmness as the gel continues to leak. The rupture can lead to capsular contracture. If your rupture doesn’t present with symptoms, it’s called a “silent rupture.”

Implant Rupture Screening

Since silent ruptures are a possibility, the FDA has screening guidelines to check for rupture problems. The first screening should occur three years following the original implant surgery, and then every two years following that. Having health insurance cover the screenings might be difficult, so you will need to discuss options with your doctor’s office.

Correcting an Implant Rupture

Unfortunately, yes, a ruptured implant is a cause for corrective surgery. This remains true whether the rupture involves gel or saline. During the surgery, the implant will be removed. Depending on the circumstances, your surgeon might remove the scar tissue capsule that surrounds the implant, or they may opt to cut through the capsule by creating small incisions. Even if only one implant is ruptured, most surgeons will remove both implants during the surgery. Any silicone that’s leaked beyond its capsule will also be removed by your plastic surgeon during the surgery. You can get breast implant replacement surgery in order to keep the look that you gained with the implants before they ruptured. Speak with Dr. Golosow about your options during a consultation appointment today!