Implant Deflation or Rupture

Breast implants don’t last forever. Eventually, all implants will deflate or develop a crack or tear in the outer shell. We commonly refer to implant deflation or rupture as “implant failure.” The saline and the silicone variety of implants both behave differently. Saline implants will simply deflate—partially or totally. It takes less than a day to notice this. Your breast suddenly gets smaller.
Breast Implant Deflation - Second Breast Surgery - Revision Breast Surgery in Austin - Dr. Caridi
In silicone implants, a crack in the outer shell of the implant occurs. There is no “free-flowing” silicone like with the saline variety. The silicone is jelly-like, solid material. The silicone stays in the implant shell or the scar tissue layer around the implant (the capsule). You probably won’t notice when a silicone implant develops a tear. In a sense, the silicone implants behave like a run-flat tire. The only sign of implant failure may be contracture or breast pain. Diseases or medical conditions do not result from a silicone breast implant tear.

What is a breast implant rupture?

Simply defined, an implant rupture is a tear or a hole in the implant shell.

Is a breast implant rupture dangerous to my health?

No. The saline implant will get smaller and the water is absorbed by your body. The silicone variety simply stays where it is, and you probably won’t know it has a small tear in the shell.

When does a breast implant rupture?

Although it can happen at any time after your augmentation, it generally occurs many years after insertion. The longer you have had an implant, the more likely it is to develop a tear in the shell. I consider an “old” implant to be older than 20 years.

How do I know if my breast implants have ruptured? 

The saline variety will get smaller to some degree. The difference is obvious and generally happens within a day or two. A silicone implant tear will not be noticeable unless the patient develops firmness of the implant or maybe some pain and discomfort. Many patients, however, won’t even know the implant has a tear, as it keeps “working.”

Does breast implant type or location above or below the muscle have any impact on the rupture rate? 

There are probably some slight differences in the rupture rate between textured and smooth implants, but this is small and not adequately studied. I don’t know of a rupture rate difference between implants above or below the muscle.

Is there any evidence that the “gummy bear” implants rupture less than typical round silicone implants? 

There is some data to suggest a decrease in rupture rate when highly cohesive or “thick silicone” material is used, but it is slight and far from being a deal breaker.

What should I do if my saline implant ruptures? How fast do I need to replace or remove my ruptured saline implant?

This is not an emergency, for sure. You can wait a week or so to get in to see your plastic surgeon. There is nothing dangerous about not seeking treatment—but the differences in your breasts may not be to your liking.

Should I get special tests if my breast implants have ruptured? 

Not really. A saline rupture is obvious. You need to decide to remove your implants or replace them with new ones. A silicone breast implant rupture is generally “silent.” It may be possible to pick up a tear in the implant with an MRI (Magnetic Resonance Imaging) exam. This has proven to be the best way to determine implant failure, but it is not foolproof by any stretch of the imagination. The fact is that most women who have silicone implants that are “working” just fine won’t seek any medical care for something that isn’t causing a problem. Patients are not going to go in for an elective MRI of their breast implants, say, 15 years after implant placement, just to see what’s going on.

Should I get regular imaging exams to make sure my implants are OK?

The FDA recommends that women with breast implants get MRI exams on a suggested schedule, but it isn’t a requirement, and few patients subject themselves to this test.

What is the best test to determine whether my implants are normal?

You would need an MRI exam. It’s similar to a CT scan, but without the exposure to radiation.

Does a breast implant leak cause any medical problems? 

There is no evidence that breast implant leaks cause medical problems.

Should I change out both implants if only one is ruptured?

Generally speaking, I would suggest changing out both implants at the same time so you have a fresh, even start with two new implants. Every generation of breast implant seems to get better.

What is the most common symptom of breast implant rupture?

A ruptured saline implant will cause immediate deflation with loss of volume and breast shape. The silicone implant may get firmer, your breast may change in shape a bit, and it may cause some pain or discomfort.

How can I tell if my silicone breast implants are leaking?

The best non-surgical way to determine whether your breast implant is leaking is to get an MRI scan. Examination by your plastic surgeon is not a good way to determine this. History helps here, though: If you have had implants for over 20 years and one becomes firmer and not as comfortable as it used to be, it’s possible you have a tear in the implant.

It is possible to rupture a breast implant with physical activity or excessive pressure on my breasts? 

Breast implants are pretty tough in general. However, the older they get, the weaker the outer shell can become, and it is possible to break them by squeezing them too hard or even by getting a mammogram.

I have had breast implants for 16 years and now they are firmer and my breast shape isn’t what it used to be. What should I do?

I would suggest you visit with your plastic surgeon and consider a breast implant revision – this would usually entail an exchange of the implants for the newest generation, and possibly removal of the implant capsule or even a breast lift if indicated.

Is there anything I can do to prevent a breast implant rupture?

Not really. The obvious thing not to do would be squishing your implants and being rough with them.

Are there breast implants that don’t rupture?

No. The only thing that wouldn’t rupture is a rock, and no woman wants rocks in her breasts. For the breast to feel soft and natural, you need an implant that is also soft and pliable. Maybe in the future implants will stay intact for life, but not right now as of 2014.

How should my surgeon manage my implant rupture if I have one? 

For saline implants, he or she simply needs to remove the implant shell (the salt water is generally all gone). The silicone implants also need to be removed (both shell and silicone filler). Removal of the implant capsule may be indicated. There could be more work involved in removing a silicone implant than a saline implant.

Why would I want breast implants if they rupture?

Breast implants are extremely powerful in many ways, and the pleasure women derive from them is real. They are not perfect, but they are the best we have. They are not, per se, dangerous.

Does a breast implant rupture lead to fibromyalgia or cancer? 

There is no scientific evidence that ruptured breast implants lead to any dangerous medical conditions.

Is the procedure for implant exchange after a rupture as bad as the first procedure?

Generally speaking, the second procedure is not as uncomfortable as the original procedure. There will be some discomfort, however, if the implant pocket is manipulated, if larger implants are chosen, or if the implant capsule is removed.

What are the causes of implant rupture?

Defective implants may rupture. This is uncommon, as the quality of the implants is quite high.

A breast contracture may cause implant rupture.

Implants, particularly older ones, may rupture during mammography.

The breast implant may be damaged by the surgeon’s tools during placement.

Over- or under-filling saline implants may be associated with higher implant rupture rates.

A breast procedure on a woman with implants (breast biopsy or cyst aspiration) can damage the implant.

Insertion of a breast implant through the belly button may damage the implant. This is a non-FDA-approved site for breast implant insertion.

Rough handling of the implant on insertion by your surgeon can damage the implant.

Trauma to your chest, as can occur in a motor vehicle accident or fall, can damage the implant.

Normal aging of the implant causes a “wearing out” of the outer implant shell.

If I have developed a medical illness and I have breast implants, should I be concerned?

Many women will develop some type of medical condition as they get older. This happens to women with and without implants. In fact, it happens to all of us—as we age we develop health problems. It’s perfectly normal to think that your breast implants may be causing your health problems, but in fact, it is very unlikely. If you have concerns about this issue, it is best to consult with your primary care doctor and your plastic surgeon.

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