What Happens When an Implant Ruptures?

What Happens When an Implant Ruptures? featured image
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If you have breast implants, the word “rupture” is probably the last thing you want to hear. Breast augmentation comes with a high degree of satisfaction, though ruptures aren’t necessarily a rare event. We’ve tapped the experts to help us understand exactly what happens when an implant ruptures, how to tell, and what to do about it.

  • Simone V. Pautler, MD is a board-certified plastic surgeon in McMurray, PA
  • Henry Mentz, MD is a board-certified plastic surgeon in Houton
  • Mark Jewell, MD is a board-certified plastic surgeon in Eugene, OR
  • Sandhya Pruthi, MD is a professor at the Mayo Clinic College and past director of the Breast Diagnostic Clinic at Mayo Clinic
  • Matthew H. Steele, MD is a board-certified plastic surgeon in Fort Worth, TX
  • David Boudreault, MD is a board-certified plastic surgeon in Palo Alto, CA

The Statistics on Implant Rupture

According to a study on implant rupture published by StatPearls, a publisher of peer-reviewed medical information that provides professional healthcare education, ruptures occur evenly across brands, implant thickness and fill technique. With over 4.2 million breast implants in the United States since 1992, the rate of implant rupture is somewhere between 1.1 and 17.7 percent. There is a notable exception, though. Mentor Implants (which are a memory gel material) have a rupture rate of 24.2 percent.

“The incidence of implant rupture increases with the age of the implant,” the study explains. “Prosthesis wall thickness does not play any determinant role in ruptures, as companies offer inflatable prostheses of varying wall thicknesses, and all have a similar rupture rate. Overfilling is rarely responsible for ruptures, though it is essential to comply with filling guidelines for any individual implant.”

Instead, the variability tends to come from the age of the implant and the number of surgical interventions that have occurred.

“Damage from surgical instrumentation during implantation is the most common cause of silicone breast implant rupture, effecting 50% to 64% of cases,” explains the Cleveland Clinic.

Other ways your implant can rupture include trauma to the breast from seatbelts or harnesses, or from a general injury to the breast area. If you’ve had an injury or trauma to the breast, you should seek medical attention.

“If a patient has had an injury to her breast, she should see her plastic surgeon for an examination and ultrasound study,” explains Eugene, OR plastic surgeon Mark Jewell, MD. “Breast trauma can produce capsular contracture.”

Depending on the type of implant you have, though, you may not really notice any symptoms.

“Keep in mind, a breast implant is not meant to last a lifetime,” explains Mayo Clinic College Professor and women’s health expert Sandhya Pruthi, MD. “You should continue to have yearly clinical breast exams.” Additionally, imaging studies like MRIs or ultrasounds are essential tools that can determine implant integrity.

How Urgent Is a Ruptured Implant?

“There are no systemic risks with a breast implant rupture,” explains Fort Worth, TX plastic surgeon Matthew H Steele, MD. He adds that because implants are not designed to be lifetime devices, an implant isn’t a necessarily uncommon occurrence.

“It isn’t at all surprising when a patient has had a rupture for quite some time, sometimes even as long as several decades,” says McMurray, PA plastic surgeon Simone V. Pautler, MD. “So, it is not an emergency.”

That doesn’t mean that you should leave it to be untreated. “I would say that you should try to get in to be treated for the rupture within the year it occurs,” Dr. Pautler says. “But if you can’t get surgery right now because of a pregnancy, for example, your surgeon might suggest waiting a while.”

In the past, though, implant rupture carried some cause for concern. “Implants manufactured prior to 1992 had a more liquid gel that could migrate into the breast tissue if a rupture occurred,” Dr. Jewell explains.

How Can You Tell an Implant Has Ruptured?

The FDA recommends that women with breast implants receive breast MRI screenings for silent ruptures three years after having breast implant reconstruction surgery and every two years after that. But Dr. Pautler points out that ultrasound technology is also good at detecting ruptures.

“An MRI can be very expensive, but a lot of practitioners have ultrasound machines in their offices,” she says. “You can also get an ultrasound at the same time as your mammogram, so a lot of the time we’re actively screening for it.”

According to Dr. Pruthi, patients with implant rupture may experience:

  • Pain
  • Swelling
  • Changes in size or shape
  • Inflammation
  • Itchy sensation

What Happens When an Implant Ruptures?

Saline Implants

For saline implants, a rupture is usually not noticed until loss of volume occurs. “Saline will leak out into the surrounding tissue and very slowly start to be absorbed by the body,” Dr. Pautler explains. “That can take several days.”

Silicone Implants

According to Houston plastic surgeon Henry Mentz, MD, silicone implants are pre-filled with a silicone gel that is similar in texture to natural breast tissue, while saline implants are filled with sterile saltwater after they have been placed in the breast. “Many patients prefer silicone because they think the gel, which is contained within a solid silicone outer shell, provides a more natural feel and look,” he says. “However, if a silicone implant ruptures, it can go easily unnoticed because the silicone tends to remain inside the capsule (intracapsular rupture) and the breast changes little in appearance. If leaking should occur with a saline implant, it is usually quickly apparent because the implant deflates.”

“When a silicone breast ruptures, it might go unnoticed because the silicone tends to remain trapped in the capsule,” explains Dr. Pruthi “This is known as a silent rupture.”

Silicone implants have had a bit of a reputation to beat as well. “In the 1990s, silicone gel implants were removed from the market to perform a 10-year clinical trial,” explain Palo Alto, CA plastic surgeon David Boudreault, MD. “It looked at whether or not silicone gel implants led to auto-immune diseases in women. The results of that study showed conclusively that the implants did not cause auto-immune disease.”

Similarly, there are no known adverse health effects to a silicone implant rupture. That said, it can be more complex to treat.

“I recently had a patient who left their rupture for twenty years,” Dr. Pautler says. “The silicone had started to leach through the capsule and there were little islands of silicone outside of the capsule that I had to remove. It wasn’t awful, but it was tedious and took a lot longer.”

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