All breast implants have an external silicone shell prone to tears or hole formations, known as gel fractures or ruptures, which compromise the shape and appearance of the implant. The ruptured implant in itself is not a source of concern. It does not cause cancer, reproductive issues, or connective tissue problems. Nevertheless, it requires immediate replacement.
Ruptures occur in all breast implant types because the compromise begins with the outer silicone shell. For instance, a saline breast implant ruptures, leaking saline to the surrounding body tissues within days. The fracture is easily noticeable because the implant appears deflated during that duration. On the other hand, gel implant ruptures may not be detectable easily because the gel oozes out slowly to the surrounding tissues.
The Cause of Ruptured Implants
There are several reasons why ruptures occur in implants.
- A study analyzing the retrieval data of ruptured implants showed that over 50% of ruptures result from implant damage by surgical instruments during the first breast augmentation procedure.
- A rupture can also develop from cracks that grow over time on the outer shell.
- Pressure exertion to the implant during a mammogram can also cause implant ruptures. However, this is a rare event.
- Any form of forceful impact to the breast, like an accident or a fall, can create fractures on the implant.
Rates of Ruptured Implants in The US
The rates of fractures occurring depend on the type of implant procedure. For instance, a review on rupture rates shows a 1.1% to 17.7% chance of a rupture occurring six to ten years after the initial breast implant surgery. The rates range from 2.9% to 14.7% after an en bloc implant removal.
The highest risk occurs after the initial breast reconstruction procedure. The likelihood of developing a ruptured implant ranges from 1.5% to 35.4%. The probability reduces when correcting a ruptured implant through a revision reconstruction to between 0% to 19.6%.
The FDA recommends a first ultrasound or magnetic resonance imaging (MRI) observation six years after the initial breast implant surgery. Follow-up checkups should follow after every two to three years.
Signs and Symptoms of a Ruptured Implant
- Changes in breast shape and size because of the leaking gel or saline. Look for sudden asymmetry or contour irregularity.
- Firmness because of the scar tissue forming a capsular contracture that squeezes the implant down. The scar tissue changes the feel of the implant from a soft pillow to a hardball that feels like lumps.
- Swelling two weeks after the implant ruptures occurs due to the building pressure, fluid accumulation around the implant, or infection.
- Pain and soreness accompany the hardening of the breast tissue and pressure from excessive scarring, inflammation, or possible infection.
Sometimes the rupture can go through a latency period where the signs and symptoms are not visible. Consult a plastic surgeon upon suspecting that something is wrong. The medical practitioner will conduct an ultrasound or MRI to ascertain the condition. Additionally, prepare to cover the examination and consultation fees because insurance does not protect against such consultation costs.
What Causes Implant Rupture?
An implant can rapture because of
- Force toward the breast from a fall or accident
- Damage from a surgical instrument
- Cracks developing from the implant’s wear and tear
- Pressure from a mammogram exam
What Is Extracapsular Breast Implant Rupture?
A rupture can either be intracapsular or extracapsular. An intracapsular rupture occurs inside a tissue capsule surrounding the implant. The fractures are tough to diagnose as the breast looks and feels normal, and the gel or saline remains contained on the tissue mass. On the other hand, an extracapsular rupture occurs when the silicone leaks gel or saline through the surrounding tissue. Symptoms of an extracapsular implant include lumps and pain at a specific breast side.
Is a Ruptured Implant Dangerous?
Although a ruptured implant is not a life-threatening emergency, it requires immediate attention. Quick action to rectify the situation reduces the degree of pocket collapse and internal scar tissue. If scarring worsens and the surrounding tissue becomes infected, or cells necrose, there may not be enough breast tissue for a revision procedure. Therefore, the further the surgery gets delayed, the higher the risks of developing a severe condition.
Will Mammogram Show Implant Rupture?
A mammogram can only detect extracapsular silicone implant fractures and not intracapsular ruptures. The mammogram uses x-ray energy, which cannot penetrate dense substances like silicone or saline. Therefore, the machine will show the rupture when the gel or saline leakage goes through, not inside the breast tissue.
Breast Implant Rupture Side Effects
The body reacts to a ruptured implant by forming scar tissue to prevent the leaking silicone or saline from spreading. Eventually, the silicone becomes hardened as capsular contracture occurs to maintain the leak. Capsular contracture is the formation of scar tissue around the rapture.
Without the scar tissue, silicone finds its way to surrounding tissue. It spreads throughout the breast tissue and muscle. The leak eventually finds its way out of the skin, where it oozes as sticky silicone gel. By the time the gel comes off through a sore, it becomes a source of infection.
The scar tissue formation causes pain, discomfort, and inflammation. It also forms a lumpy and irregularly contoured breast.