How to Tell If You Have an Implant Rupture (And What to Do About It)

Breast implant manufacturers concur that breast implants are not considered lifetime devices—they may rupture or deflate. While ruptures can occur at any time after surgery, they are more likely to transpire the longer the implant has been implanted.

Why do ruptures occur?

Ruptures can happen for various reasons, including, but not limited to:

• closed capsulotomy
• trauma to the breast
• injury from surgical instruments
• normal wear and tear on the implant
• severe cases of capsular contracture
• mechanical damage prior to or during surgery

Types of implant rupture

There are two types of ruptures: silent and symptomatic.

• Silent rupture of silicone gel breast implants - A silent rupture is when an implant ruptures, resulting in no symptoms. This means that neither you nor your surgeon would know of the rupture without some sort of diagnostic imaging such as a MRI (magnetic resonance imaging). Because most silicone breast implant ruptures are silent, a MRI is recommended at three years post-op, and every two years thereafter to screen for rupture. This is a phenomenon that has increased in frequency due to the use of thicker (“cohesive”) silicone gel implants that maintain their shape following rupture, unlike earlier versions of leaking implants that would distort.
• Symptomatic rupture - A symptomatic rupture is when an implant ruptures, producing glaring symptoms that cannot be ignored by the patient.

Symptoms of breast implant rupture: Silicone vs. saline

Silicone gel breast implants - Rupture/deflation symptoms

Below is a photo of a woman with a ruptured saline breast implant. As you can see, her left breast lacks the fullness of the right breast.

Silicone leaks tend to occur very slowly, and for this reason, some may be unaware of its occurrence for several years—unless, of course, symptoms arise.

So, where does the silicone go?

The leaking silicone may stay within the capsule, which is protected by a thick layer of scar tissue that forms naturally around the implant. In this instance, the silicone will stay where it is. However, should the silicone leak outside of the scar tissue capsule, the silicone can move to other regions of the body, such as the lymph nodes under the arm. The likelihood of this happening grows the longer the leak is ignored.

Saline breast implants - Rupture/deflation symptoms

The main symptom of rupture/deflation in saline breast implants is also a visible change in the shape and/or size of the breast. Additional symptoms include:

• increasing pain and tenderness
• changes in nipple sensitivity
• loss of upper pole fullness
• rippling and/or indentation of the tissue
• redness of the skin
• capsular contracture, which can lead to inflammation of the capsule (capsulitis)
• fever

Saline ruptures tend to happen rather quickly. It can also happen slowly, but this seems to be rare. Slow leaks would likely come from a very tiny opening at the top of the implant. As the saline leaks out, it is reabsorbed into the body and excreted during the body's waste removal process. However, some may remain around the ruptured implant, and this can cause the fluid to change color. Light, clear fluid usually signals that the ruptured occurred within a month. Dark, yellow, straw colored fluid tends to indicate that the rupture has extended over several months.

Saline leaks are generally harmless, unless bacteria or fungus are inside the implant. In such cases, an infection can arise, leading to fever and redness of the skin.

Understanding the consistency of saline and silicone gel implants

The silicone gel breast implants of today are much different than the silicone implants of the 70s and 80s. Today's gel implants are cohesive, meaning that the silicone gel inside of the implant shell cannot "spill" in the event of a puncture or tear in the implant shell. To better understand this, watch the video below. The video will show you three types of implants—saline, cohesive silicone gel, and the old-style silicone gel implants—and how they react when the shell is punctured.

How do I know if my implant has ruptured? From Dr. Steven Teitelbaum

Reviewed November 2016