Breast implants are a lot like a custard doughnut – the implant shell is the dough and the filling is the custard. Sometimes, the implant shell can split or tear open, and, like when you bite into a custard doughnut, the filling leaks out of the hole. When this happens with an implant, it’s called a “rupture”, “deflation” or a “leak”.

What causes an implant shell to rupture?

Trauma – sometimes

Breast implant ruptures can be caused by trauma, such as from a seat belt in a car accident.  It can also be caused by excessive compression, such as during a mammogram.

Wear and tear – most commonly

Most women, however, say that there was no trauma before the rupture.  This leads us to the the most common cause of implant rupture: “wear and tear” over time.  Over the years, the normal aging process of your implants can cause rupture in one or both breasts.  Remember that the implants are designed move around somewhat within your breasts. This is good because it makes the breasts look “natural” and not “glued” to your chest.  This continuous movement can cause the implant shell to experience rubbing. This rubbing, in turn, can eventually form a little tear in the shell.

Think about a brand new sweater than you just bought.  Then compare it to your favorite sweatshirt from high school.  The high school sweatshirt probably has some fading of the colors and threadbare spots around the collars and cuffs.  This “wear and tear” is a normal part of any device or object.

That is why breast implants should not be considered lifetime devices. Breast implants will develop wear and team, just like anything else.  These days, however, the implant shells are designed to be thicker and sturdier, so we expect that the rupture rates will be lower than before.  

Detecting rupture depends on the type of implant you have

How can you tell if your implant is ruptured?  Well, that answer depends on whether your implant is saline or silicone.

Saline implant rupture

They just go flat

If you have saline implants, it’s usually easy to tell when your implant deflates. If the implant shell breaks, the saline inside it will be absorbed by your body, and that breast will get much smaller.  Some women describe it as like getting a “flat tire”.

Sometimes the leak is slow

With very small leaks, you may notice the breast getting progressively smaller over time.  But many women describe waking up and right away, noticing that one breast is much smaller than the other. Most women cannot remember any trauma to the breast before the rupture happened.

Silicone implant rupture

New gummy implants don’t go flat

With silicone implants, you probably won’t realize if one of your implants ruptures. Most women experience a “silent rupture” where they don’t experience any signs or symptoms at all.¹

One reason why “silent rupture” happens is that the capsule that develops around your implants keeps the silicone contained, so you don’t have any silicone gel leaking into your breast tissues. The capsule keeps the implant shape the same, so you can’t tell from the outside whether you have a rupture or not. If you have gummy implants, another reason for a silent rupture is that while the silicone shell might break, the inner gel’s thick cohesivity keeps the implant’s shape.

But look for subtle signs

Even though silent rupture is common with silicone implants, some women do have certain symptoms of ruptured implants. You might notice some asymmetry between the breasts if one implant is ruptured and the other isn’t. If you have severely ruptured silicone implants, you may notice hard lumps in your breast. Ruptured silicone may also trigger capsular contracture in your breast, so you may see the entire implant hardening and lifting over time.

You think you have a rupture, what are the symptoms?

Usually no pain

Most women do not experience pain with a rupture.  At most, they might say they have a slight discomfort in that breast, especially when the implant is moved.  This may be due to the implant having collapsed and you might be feeling an “edge” of the implant when it is moved.  

Sometimes the breast changes looks

If you see changes in the look of your breasts and you’re concerned that your implants might be ruptured, the best thing to do is to schedule an appointment with your plastic surgeon.  If it is a saline implant, it will probably be obvious to your surgeon that the implant is ruptured and you can proceed with surgery right away.

You may need a breast MRI

If you have silicone implants, your surgeon may recommend getting an MRI first.²

An MRI, or magnetic resonance imaging, is what both the FDA and implant manufacturers recommend to find out if there is a rupture. An MRI allows us to see into your body to check the implant’s shell without having to do surgery. A mammogram is not precise enough to tell if you have an implant rupture.  It’s an MRI that’s recommended.³

 Once the MRI shows that you have a ruptured implant, it’s time to think about surgery.

What is the treatment for ruptured implants?

Don’t wait too long

It’s best not to wait too long between knowing that you have a rupture and having surgery.  Every day, the scar tissue in the ruptured breast is clamping down around that ruptured implant.  The entire breast contracts because the implant is no longer holding that shape open. This changes that breast more and more over time.  If you wait a long time between rupture and replacement, even when you get new implants put in, your left and right breasts may never quite look the same. That’s because there’s been permanent changes in the breast that had the rupture.  

Remove the ruptured implants

Whether you have silicone or saline implants, the FDA recommends removal if they rupture.⁴

You can decide at that point whether you would like to just remove them, or if you want to replace them. Some women change their implants to a larger or smaller size.  Some will want to add a breast lift at the same time. Others may switch from saline to silicone implants. This is an opportunity for a “do-over”, so think about all the things you wish you could change about your breast and discuss that list with your surgeon during your consultation.  They will go over what parts of the “wish list” are possible and which are not.

May need capsule modification or removal

At the same time as your breast implant surgery, your surgeon may need to modify or remove the capsule around your implant. This may be needed to change the way the breast looks, or to correct deformities that may have existed. If the breast implant has been deflated for a long time, the breast capsule may have shrunk and will need adjustments to allow new breast implants to be placed.

Consider doing both sides

Even if only one side has ruptured, we recommend changing out both implants. Because your implants are the same age, it is possible that the other implant will rupture shortly after the first.  Most people would rather replace both implants at once, rather than risk having to undergo another surgery for the other side later.

Think about what new size you want

Remember, if you were considering going fuller or smaller on the implants, here’s the time to do it since a new implant would be placed anyway. Be sure to bring your old breast implant information card (if you have them) to your appointment with your plastic surgeon. Together, you can discuss what your options are.

In the Temecula or Murrieta area?

The possibility of an implant rupture scares a lot of people. We’re experts on this. Come by and chat with one of our board certified plastic surgeons to discuss everything you need to know. We’ll help make this process as simple and easy as possible.

1. Hillard, Christopher, Jason D. Fowler, Ruth Barta, and Bruce Cunningham. “Silicone breast implant rupture: a review.” Gland Surgery 6, no. 2 (2017): 163.
2. Hölmich, Lisbet Rosenkrantz, Jon P. Fryzek, Kim Kjøller, Vibeke Bro Breiting, Anna Jørgensen, Christen Krag, and Joseph K. McLaughlin. “The diagnosis of silicone breast-implant rupture: clinical findings compared with findings at magnetic resonance imaging.” Annals of Plastic Surgery 54, no. 6 (2005): 583-589.
3. US Food and Drug Administration. “FDA update on the safety of silicone gel-filled breast implants.” Silver Spring, Md: Center for Devices and Radiological Health (2011).
4. US Food and Drug Administration. “FDA update on the safety of silicone gel-filled breast implants.” Silver Spring, Md: Center for Devices and Radiological Health (2011).