How is it possible that my cohesive silicone implant that’s 2.5 yrs old ruptured?

I have cohesive silicone gel implants by Mentor that were placed ~2.5 years ago. I had to get an MRI & mammogram done for breast cancer screening, which is when they found that my right implant is ruptured. I’ve noticed the right was smaller than usual lately but thought it was normal asymmetry. I recall no trauma of any sort and I am very careful with my implants. How could this rupture happen in relatively new implants? Is it possible the mammogram ruptured my implant or made it worse?

ANSWERS FROM DOCTORS (2)


Answered by Zenn Plastic Surgery

With newer cohesive implants, implant rupture is harder to diagnose and has less clinical significance when compared to older generation implants. The cohesive (think "solid") nature of the inner fill means that even if there is a tear in the implant's outer capsule, the silicone fill does not go anywhere. In comparison, older generation implants had silicone gel that was more of a liquid consistency and when the outer shell had a tear, the inner silicone material would rupture through and migrate, often distant to the implant. In those cases, the implant needed to be removed with all the silicone material.

Now, it is a radiographic finding only and not even 100% diagnostic. There have been times when I have gone in to remove these "ruptured" implants only to find they were not even ruptured, just wrinkled from scar tissue. I recommend that if there are no clinical symptoms and you are happy with size and shape, leave them alone.

The size discrepancy in your case may be a reflection of more scar tissue (capsular contracture) on one side versus the other. Mammography in these situations is fine and should not make things worse and likely did not cause the problem. A visit to a trustworthy board-certified plastic surgeon should help you to sort things out.

Published on Nov 11, 2018

Answered by Zenn Plastic Surgery (View Profile)

With newer cohesive implants, implant rupture is harder to diagnose and has less clinical significance when compared to older generation implants. The cohesive (think "solid") nature of the inner fill means that even if there is a tear in the implant's outer capsule, the silicone fill does not go anywhere. In comparison, older generation implants had silicone gel that was more of a liquid consistency and when the outer shell had a tear, the inner silicone material would rupture through and migrate, often distant to the implant. In those cases, the implant needed to be removed with all the silicone material.

Now, it is a radiographic finding only and not even 100% diagnostic. There have been times when I have gone in to remove these "ruptured" implants only to find they were not even ruptured, just wrinkled from scar tissue. I recommend that if there are no clinical symptoms and you are happy with size and shape, leave them alone.

The size discrepancy in your case may be a reflection of more scar tissue (capsular contracture) on one side versus the other. Mammography in these situations is fine and should not make things worse and likely did not cause the problem. A visit to a trustworthy board-certified plastic surgeon should help you to sort things out.

Published on Jul 11, 2012


Answered by Harry Glassman, M.D.

I agree with you that it is very unusual for a cohesive gel implant to leak after 2+ years. The possibilities are (1) it was damaged during insertion, (2) a highly excessive pressure was applied during mammography, or (3) your MRI is a false positive (occurs in 5-10% of MRI's). You should return to see your surgeon and consider repeating the MRI in 2-3 months. Be assured that having a broken silicone implants is not an emergency and should have no systemic effects on you.

Published on Nov 09, 2018

Answered by Harry Glassman, M.D. (View Profile)

I agree with you that it is very unusual for a cohesive gel implant to leak after 2+ years. The possibilities are (1) it was damaged during insertion, (2) a highly excessive pressure was applied during mammography, or (3) your MRI is a false positive (occurs in 5-10% of MRI's). You should return to see your surgeon and consider repeating the MRI in 2-3 months. Be assured that having a broken silicone implants is not an emergency and should have no systemic effects on you.

Published on Jul 11, 2012


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