An implant leak or rupture occurs when the outer shell develops a tear, allowing the internal contents to escape into the surrounding tissue. Maintaining implant integrity is important for long-term health and the aesthetic result of augmentation or reconstruction. While a rupture is generally not a medical emergency, early detection is crucial for managing changes, minimizing discomfort, and planning for replacement or removal. Understanding how different implant types fail is the first step in seeking professional medical evaluation.
Saline Versus Silicone: Understanding Rupture Behavior
The way an implant ruptures depends on its internal filling material, which dictates the severity and speed of noticeable symptoms. Saline implants are filled with a sterile salt water solution, and a breach in the shell is usually obvious and happens quickly. The sterile saline is absorbed harmlessly by the body, but the implant rapidly deflates, often within hours or days. This rapid volume loss leads to an immediate change in the breast’s size and contour.
In contrast, a silicone implant rupture is a more gradual event, often called a “silent rupture.” Silicone gel is highly cohesive and viscous, meaning it tends to stay localized within the fibrous capsule the body forms around the implant. This containment, known as an intracapsular rupture, prevents immediate deflation, allowing the rupture to go unnoticed. The risk of rupture increases significantly after the first decade, necessitating regular monitoring because the lack of symptoms can be misleading.
Recognizing Physical and Visual Signs of a Leak
Observing changes in the breast is the primary method for self-assessment, though the signs differ greatly between the two implant types. For a saline implant, the most apparent sign is a noticeable reduction in breast size or marked deflation, leading to sudden asymmetry. The affected breast may also show visible wrinkling or rippling of the deflated shell under the skin.
Silicone implant ruptures often present with subtle, non-visual symptoms due to the gel’s cohesive nature. Increased firmness or hardening of the breast can be a sign of the body’s reaction to the rupture or the development of capsular contracture. Persistent pain, tenderness, or a burning sensation can occur as the leaked silicone irritates the surrounding tissue.
Visual changes, while less dramatic than with saline, can include a subtle change in breast shape or size, making one breast appear misshapen or slightly smaller over time. If the rupture is more extensive and the silicone gel moves outside the fibrous capsule (an extracapsular rupture), small lumps may be felt. These lumps, also called siliconomas, may appear in the breast tissue, near the chest wall, or even migrate to the armpit and cause lymph node swelling. These observations are only indicators, and a professional medical evaluation is necessary for a definitive diagnosis.
Professional Diagnosis: Imaging and Verification Methods
Because of the high incidence of “silent ruptures” in silicone implants, medical imaging is necessary to confirm or rule out a breach in the shell. Magnetic Resonance Imaging (MRI) is considered the most reliable method for assessing the integrity of silicone implants, boasting an accuracy rate often greater than 90%. An MRI can identify specific signs of rupture, such as the “linguine sign,” which represents the collapsed implant shell floating within the silicone gel.
The “keyhole sign” or “teardrop sign” is another finding, indicating silicone trapped within a deep fold of the implant shell. This is more common with modern, cohesive gel implants. The U.S. Food and Drug Administration (FDA) recommends that individuals with silicone implants undergo their first screening with MRI or ultrasound five to six years after implantation, followed by a repeat screening every two to three years thereafter.
Ultrasound is a non-invasive and less costly screening tool that can be used as an initial assessment, especially for detecting signs of extracapsular rupture. It can show a “stepladder sign,” which is the ultrasound equivalent of the MRI linguine sign, representing collapsed folds of the shell. If a patient has symptoms or the ultrasound results are inconclusive, an MRI is still the recommended next step for definitive verification. While mammography is primarily used for cancer screening, it is less effective for rupture detection because the implant can sometimes obscure the view of the surrounding tissue.
Next Steps After Suspecting or Confirming a Rupture
If you notice any physical changes or experience new symptoms, contact your plastic surgeon or healthcare provider immediately. A prompt consultation allows for a thorough physical examination and the scheduling of appropriate diagnostic imaging, which is the only way to verify a rupture. It is important to remain calm, as a ruptured implant is rarely an urgent medical emergency.
You should locate your original implant information, often provided on a device card, to review the manufacturer’s warranty and determine coverage for replacement or removal. Once a rupture is confirmed through imaging, your surgeon will discuss treatment options. These typically involve surgical removal of the damaged implant and any leaked silicone. A person may choose to have a new implant placed during the same procedure or opt for removal without replacement.