Stephen McCulley, Reconstructive and Aesthetic Surgeon. MBChb, FCS(SA)Plast, FRCS(plast)

How to Tell if Your Breast Implant has Ruptured

All breast implants need to be replaced at some point in time, whether they are filled with a silicone gel or a saline solution. Most manufacturers state that their implants will last around 10 years, though many women report their implants lasting much longer with no problems. If implants are not removed or replaced, they will come to the natural end of their lives after a period of time and in some cases they will rupture. There is usually no danger when this happens, though it is important to contact your surgeon as soon as you suspect this may have occurred.

The image below shows a patient with encapsulated implants feeling very hard. Up to 50% of implants older than 15 years may have a rupture; however, silicone is usually held within the capsule – this is known as intracapsular rupture. Around 5% of these will progress to giving lumps outside of the capsule and this is called extra-capsular rupture.

Problems that arise from this situation are usually physical, not chemical i.e. — there is no chemical reaction between the contents of the implants and the body, rather the shape of the breast may change or lumps may form in or around the chest.

Below is a guide designed to help you spot signs of a rupture and show you what to do when this occurs.

Signs that a breast implant has ruptured

To begin with, the table below offers some terms commonly used when describing a breast implant rupture:

Terms

Meaning

Silicone gel

A viscous material derived from silicon

Saline solution

Salt water

Capsule

A surrounding shell of soft scar tissue that the body naturally forms around an implant

Intracapsular

Occurring inside the capsule formed by the body around the implant

Extracapsular

Occurring outside the capsule formed by the body around the implant

Asymmetry

A lack of evenness, in this context, between breasts

Capsular contracture

When tissue that forms around the implant becomes hard and fibrous, in some circumstances altering the shape of the breast

Migration

The movement of silicone gel from inside the implant to areas of the body

There are generally two types of breast implant: those filled with a silicone gel and those filled with a saline solution. When a silicone implant ruptures the effects are often very slow to become apparent. Ruptures to saline-based implants are quicker to spot as the results of a leak on breast size and shape can be quickly observed.

Possible warning signs

When an implant ruptures, you may notice the following effects:

Silicone gel

Saline

  • Numb or tingling feeling in the breast
  • Soreness and discomfort in and around the breast
  • Small lumps in and around the breast, armpit or arm
  • Increased firmness of the breast
  • Change of breast size and shape
  • Softening of the breast area
  • Breast asymmetry
  • Redness of skin
  • Hyper sensitivity
  • Marked reduction in size
  • Change of shape
  • Observable rippling or indentation of the breast
  • Slight tenderness
  • Breast asymmetry
  • Redness of skin
  • Hyper sensitivity

Why do breast implants rupture

All breast implants will break if they are not replaced after a period of time. The length of time that an implant lasts varies considerable according to when they were made and if they have been subject to any trauma. This can include:

  • Small needle punctures occurring during the breast augmentation procedure
  • Punctures following a breast biopsy
  • Over-vigorous massaging of the breast, which is standard after surgery to break down any excessive scar tissue around the implant to avoid capsular contracture
  • Trauma that may result from a serious fall or other violent impact

Ruptures may also occur as a result of small, unavoidable imperfections in the silicone shell of the implant.

What happens inside the breast when an implant ruptures?

When a rupture occurs, the material inside the implant leaks into the cavity of the implant. In some instances some of the material can move into local breast tissue or through the lymph node system. The type of implant will determine where the filling may migrate to and the speed with which it disperses.

Silicone gel

In most cases, silicone gel from a ruptured implant will stay within the capsule of tissue formed by the body around the implant. This is known as an intracapsular rupture. As there may be no symptoms, either physically or visually, this type of rupture can go unnoticed for several years.

When the silicone gel does move outside the capsule, the shape of the breast may be altered. In some cases, the gel will migrate away from the breast and collect together in the chest, armpit or arm area to form small lumps. The area around these may feel sore and tender. This type of rupture is known as ‘extracapsular’.

Silicone-gel ruptures are usually slow acting, meaning the material leaks out over a period of months or years.

Saline

When a saline implant ruptures, the shell quickly deflates and harmless salt water escapes into the surrounding area. This water is then absorbed by the body’s cells and offers no medical problems, such as migration or lumping. However, if left unattended, a number of issues can arise:

Capsule shrinkage: The capsule that previously formed around the implant begins to shrink, altering the breast shape and making it more difficult to replace the implant with one of a similar size.

Extrusion: Edges, now sharp after deflation, work their way to the surface of the skin causing pain and scarring.

What are the health implications of a ruptured implant?

There is no definitive research to suggest that there are any serious health implications connected with the rupture of breast implants beyond the presence of physical material in the body, which can be removed. However, once a rupture has occurred and is extracapsular then replacement is recommended. Intracapsular ruptures are also usually changed but this is not urgent.

Silicone gel

The major issue with ruptured silicone-gel implants is that the material within the implant can migrate to other parts of the body. Evidence does not suggest that this will lead to any serious symptoms; however, if left unchecked, the gel may travel to locations that are hard to reach, risking the possibility that it will remain there indefinitely.

Saline

There is no evidence that the presence of saline solution within the body is in any way harmful.

What to do if you think your breast implant has ruptured

If you think your implant has ruptured it is recommended that you contact your GP or surgeon as soon as possible and arrange for an assessment. Although there is no threat of serious health problems, the sooner a course of action is decided upon — either replacement or complete removal — the quicker incidents of capsule shrinkage, extrusion, gel migration and lumping can be mitigated.

Your surgeon will perform one of three actions to confirm whether or not you have a ruptured implant:

  • Mammogram. Only show gross signs of rupture with silicone in the breast.
  • Ultrasound. Often the easiest and most convenient method. Most surgeons recommend this test.
  • MRI. A very sensitive test that will confirm if there is a problem. Most surgeons recommend this test if uncertain from ultrasound.
  • Surgery. The only way to be sure, but requires an operation.

If you have any concern about your breast implants and would like to speak to Stephen then please contact our Nottingham clinic on 0115 962 4535. You can find out more about the potential risks of breast surgery with Your Guide to Breast Augmentation and the Associated Risks.