Silicone Breast Implant Rupture
I suspect I have a leak in my silicone breast implant, what now?
Unfortunately breast implants can fail, either saline or silicone. If a saline breast implant fails, this results in deflation of the implant which is quite easy to diagnose most of the time. Rupture of a silicone breast implant can be a more significant diagnostic dilemma. There are often no external signs with an early rupture. This is the so called “silent rupture”. With time, this could eventually lead to capsular contracture, deformity of the breast and/or silicone migration into the breast tissue. The rate of silicone breast implant failure is a little less than 1% per year. This is lower than the failure rate of saline implants which could be due to a number of factors including missed “silent ruptures”, intrinsic resistance to failure of silicone implants, or fewer “fold-flaw” ruptures.
Signs of a possible silicone breast implant failure include:
- Change in implant or breast shape
- Hardening of the implant (contracture)
- Deformity around the implant (see your doctor if there are concerning “lumps”)
- Older implants (>20 years)
The most accurate method of diagnosis of a ruptured implant is MRI. The FDA has recommended MRI studies at 3 years after augmentation and at regular intervals thereafter to diagnose “silent ruptures”. This is controversial as an MRI is quite expensive and would only benefit the less than 1% of patients who have a rupture at 3 years.
Does silicone breast implant rupture cause illness?
Breast implant illness is controversial and there is conflicting evidence as to whether it actually exists or not. The FDA has looked extensively at the safety of silicone implants. In 2006, the implants were again released for use with breast augmentation. The “FDA has reviewed an extensive amount of data from clinical trials of women studied for up to four years, as well as a wealth of other information to determine the benefits and risks of these products,” said Daniel Schultz, M.D., Director, Center for Devices and Radiological Health, FDA. “The extensive body of scientific evidence provides reasonable assurance of the benefits and risks of these devices. This information is available in the product labeling and will enable women and their physicians to make informed decisions.” The conclusion was that the implants were “safe” and that women could decide for themselves. The post approval studies are currently underway to look at data for a longer period of time. There was found to be a small association with fibromyalgia with extracapsular silicone rupture (silicone beyond the scar tissue capsule which contains the implant). For more information review my blog about breast implant illness.
Do ruptured silicone implants need to be removed?
Silicone implant rupture generally requires removal and replacement to avoid more significant problems in the future. As opposed to saline implant deflation, silicone implant rupture can be difficult to deal with surgically. When a saline implant deflates, the saline is absorbed by the body. The silicone is not absorbed and can be difficult to remove completely surgically. Oftentimes, the capsule around a ruptured silicone implant becomes hard (capsular contracture) requiring removal of the capsule in addition to the implant. The good news is that the newer generation of silicone implants are more resistant to failure and more cohesive (more solid) decreasing the rates of some of these problems.