Although the term rupture is used for silicone gel-filled and saline-filled breast implants, the term deflation is typically used only for saline-filled implants. We need to understand that when a doctor refers to a ruptured breast implant, it is a typically a tear or hole in the outer shell of the breast implant.
Silicone gel is thicker than saline, so when a silicone gel-filled implant ruptures, the gel may remain in the shell or in the scar tissue that forms around the implant (intracapsular rupture). All breast implants have the risk that they may break. Some even break during the first few months, but the older your implant is, the more likely it is to break. However, it is not always obvious when an implant is broken.
What Causes Breast Implants to Rupture?
- capsular contracture;
- compression during a mammogram;
- damage by surgical instruments;
- damage during procedures to the breast, such as biopsies and fluid drainage;
- normal aging of the implant;
- over-filling or under-filling of saline-filled breast implants;
- physical stresses to the breast such as trauma or intense physical pressure;
- placement through a belly button (umbilical) incision site, which requires more handling of the implant; or
- too much handling during surgery.
How do I know if my Breast Implant has Ruptured?
Most women have no signs or symptoms when a silicone breast implant ruptures. However, some women may experience:
- Pain, burning, tingling, swelling, numbness or redness in the affected breast
- Hard knots or lumps surrounding the implant or in the armpit
- Change in breast size or distorted breast shape
- Softening or hardening of the breast
In cases where there is no symptoms or signs, it is called a “silent rupture”. In this case, you would not know that your implant has broken.
What can happens to me when a Breast Implant Ruptures?
If your silicone gel implant ruptures, you might notice a change in the size or shape of your breast. Or you might feel pain or tenderness, swelling, numbness, burning or tingling. When a silicone implant breaks or ruptures, one of two things can happen to the leaking silicone gel. One possibility is that the leaking silicone can be contained within the scar tissue capsule, which is the thick layer of scar tissue that naturally forms around the implant. When this happens, the silicone stays within it’s cavity created at the time of surgery. Occasionally the silicone can migrate outside of the scar tissue capsule and lodge in the lymph glands under the arm or in the subcutaneous tissue of the breast or adjacent area. These collections of silicone gel are called silicone granulomas as the body produces an inflammatory response to the free silicone in the tissue. The longer a silicone implant remains within the body, the greater the chance of developing a granuloma.
How can I find out if my silicone implant has ruptured?
The first thing you should do is consult with your original surgeon or to get a referral from your GP to a Breast Surgeon. They can accurate then plan a course of action and investigation into the suspected breast implant rupture.
Physical examination will be preformed by your doctor first to determine if they suspect a rupture or Capsular Contracture either way this will need to be confirmed. Aside from surgery, the best way to confirm a rupture is with an MRI, or perhaps an ultrasound. These methods require a trained eye to see a leak or rupture. A mammogram is not accurate enough to find a rupture or leak.and then if warranted you will be referred to undergo Magnetic Resonance Imaging (MRI) as is the most effective way to detect silent rupture of a silicone gel-filled breast implant with 76-95% of ruptures detected.
The FDA and implant manufacturers recommend that women with silicone gel-filled breast implants undergo MRI screening three years after they receive a new implant and every two years after that for early detection of a silent rupture. The FDA recommends using MRI equipment that is specifically designed for imaging the breast for evaluating patients with suspected rupture or leakage of their silicone gel-filled implants.Since most women don’t always notice when a silicone gel implant breaks, it is important to have an MRI to check for leakage.
I have confirmed I now have a rupture breast implant, what now?
If after your MRI your doctor confirms that you do have a rupture implant, most experts agree that it is important to remove a ruptured implant especially if it contains silicone gel. Removal of implants is called explantation.
It is important to have ruptured silicone gel implants removed as soon as possible. The longer the silicone is allowed to remain in the body, the more time it has to migrate to other parts of your body, like the lymph glands. If the lymph glands do contain silicone gel these may need removal as well. Unfortunately, there is no definitive answer to what will happen if silicone is free in the body tissues.
What does the breast implant removal surgery involve?
It can be easy or difficult to remove breast implants, but it is almost always more complicated to remove a silicone gel implant than it was to put it in. This is especially likely if the implant has ruptured, because it’s important that silicone gel from a broken implant does not spill or remain in the body.
Some cosmetic surgeons are very experienced at putting implants in, but not at taking them out. However, there are many plastic surgeons who are very experienced at removal and are skilled at getting the best possible cosmetic result. The surgeon you choose should be experienced with explantation(breast implant removal), and should be willing to show you pictures of what the patients looked like after their implants were removed
You should have your surgeon explain exactly what they intend on doing prior to agreeing to surgery. You should make sure that when your implants are removed, the scar tissue capsule is also removed, because it might contain bacteria or chemicals from the implants.
Most experts believe that removing the implants ‘en bloc’ is very important. This means that the entire implant and the entire scar tissue capsule surrounding it are all removed together. Removing implants en bloc makes it easier to remove any silicone that leaked from a broken gel implant, and also helps remove silicone or other chemicals that may have bled from the silicone outer envelope. You should ask your doctor if he or she has experience doing an en bloc removal.
What happens if I remove my implants and don’t replace them?
Some surgeons discourage patients from removing their implants without replacing them, because they believe implants are safe and because they’re concerned that the patient will be very unhappy with her appearance after the implant is removed. The breast tissue stretches from the implant, and if the surgeon isn’t skilled in explantation without replacement, the breast is unlikely to be as attractive as it was before the implant surgery.
If the surgeon is not skilled at removing ruptured implants, the silicone can spill into healthy breast tissue, which then may need to be removed as part of the surgery. However, after an experienced explant surgeon removes implants, many women are very pleased with the way their breasts look and feel.