How do you know if have a ruptured breast implant?
Breast implants usually last a lifetime without causing any problems. Nevertheless, saline or silicone implants may sustain a tear or a hole due to a number of reasons, and the material then leaks out to surrounding breast tissue. This is called “breast implant rupture”, and it’s important to recognize the possible signs in order to identify the problem and seek proper help early on.
What can cause breast implant rupture?
Breast implants are usually very resilient and do not rupture easily. However, in some uncommon instances, implants may rupture for any of the following reasons:
- Normal ageing of certain types of implants can eventually lead to some wear and tear, and cause the implant to rupture.
- Persistent folds for long time of the implant, especially in softer implants for long time
- Older generations implants, with soft shell, ageing and underfilled, which can favor the folding
- Capsular contracture keeping implants in a ’forced’ tight position, causing weakening of the shell and subsequent rupture
- Intense physical trauma to the breast, such as a car accident, can lead to breast implant rupture
- Intense exercise, on a previously weakened implant shell
- Accidental perforation during the initial implant surgery is thought to be responsible for a number of cases of breast implant rupture. The implant can sustain a microscopic perforation during insertion, which in turn becomes larger and leads to frank rupture later on. That was the case mainly in the past, when implants were inserted through very small incisions, thus favoring trauma, gel fracture an microlesions of the shell at the time of rupture. With modern insertions techniques, using insertion sleeves and atraumatic ‘no touch’ manipulation of implants, this incidence was reduced.
- Accidental perforation during a breast biopsy for reasons unrelated to the breast implant, such as when your doctor is investigating a certain breast mass.
- Compression during a mammogram can be one of the causes, so you might want to alert the technician to be careful while performing the test. It is a special technique described to image the implanted breast, that specialists in breast imaging should be aware of. That can reduce, but not completely eliminate, the risks of subsequent trauma and rupture.
Physical manipulation that is NOT traumatic and things like coughing or sneezing do not usually cause breast implants to rupture. A lot more energy is needed for the incident to occur.
What are the symptoms of breast implant rupture?
What are the Symptoms of a ruptured breast implant?
Symptoms can differ based on whether you have a silicone or a saline breast implant, however, a lot of them can overlap:
- Losing breast size: this is particularly noticeable with saline implants, where the implants can fully deflate within 2 or 3 days after sustaining a perforation, and the saline solution leaks out and becomes completely absorbed by the surrounding tissue. This abrupt loss in breast size will immediately alert you that your breast implant has ruptured. Saline solution is just saltwater and does not cause any problems if absorbed by your body.
- Misshapen breast: If you have a ruptured silicone implant, you might not notice any loss in size for a long time. The reason is that silicone is a thick gel-like material that is not absorbed by your body, so it tends to stay in place even if the implant has ruptured. Nevertheless, your body will try to contain the free silicone seeping in your breast tissue by forming scar tissue around it, called “granulomas” or “silicomas”. Over time, this scar tissue growing around the free silicone can form hard capsules and contractures, causing your breast shape to change by noticeable deformities.
- Pain in your breast: pain can be caused by the material pushing against the normal breast tissue and underlying muscle, inflammation, or stretching of the overlying skin due to loss of breast size and breast drooping.
- Breast lumps: Specifically with silicone implants, even if the breast shape and size are unchanged, discovering a new lump can be a sign of implant rupture and is worth investigating.
- ‘Hardening’ of the breast, as the body reacts by creating a tight capsule around the breast, either making your capsular contracture worse or developing a degree of contracture if it as not an existing one
- Limited mobility- a breast that was moving freely with gravity and movement that doesn’t anymore, becomes’ stuck’ in time, you notice that the mobility is decreasing with time
Is my implant ruptured ? – How breast implant rupture is diagnosed
If you think your breast implant has ruptured, you should immediately call your plastic surgeon and let them know of your concerns. Your surgeon will ask you to make an appointment to come in to undergo a thorough physical exam.
If they suspect that you might have a ruptured breast implant, your plastic surgeon might order an ultrasound scan or MRI of the breasts. MRI (magnetic resonance imaging) is considered the best imaging modality for assessing breast implants. Unfortunately, it’s somewhat expensive and might rarely miss perforations, especially if they are small. Instead, an ultrasound might be recommended if clinical suspicion is not strong, which will be non-invasive, less expensive and easier to tolerate. A good sonographer might be able to identify direct or indirect signs of rupture and capsular contracture.
How is breast implant rupture treated?
If your breast implant has ruptured, you will need to visit an experienced certified plastic surgeon for corrective surgery. The corrective surgery for breast implant rupture is complicated and more technically demanding than the initial implant surgery.
During explantation surgery, a plastic surgeon will make an incision in your breast and remove the ruptured implant. If you had had a silicone implant, the surgeon will remove any granulomas and scar tissue that formed after its rupture. You might need an operation on the contralateral breast as well, as the breast implants would have the same age, same risks of rupture, and in order to achieve symmetry, you might need to have the same implants in both breasts.
Your plastic surgeon might offer you new implants during the same surgery, usually of a different type. You can also discuss other breast augmentation techniques, such as fat transfer to your breasts.
Is breast implant removal covered by Medicare and insurance?
Even though most insurance companies do NOT cover complications from previous cosmetic surgeries, breast implant rupture is usually considered by many third-party insurers as a medical necessity, and hence the costs of implant removal ARE usually covered to a certain extent.
Medicare also covers some of the costs of implant removal in case of rupture, infection, disfigurement, extrusion, or granuloma (silicoma) formation.
The cost of the new implant reimplantation is rarely covered.
Who is the best breast surgeon to treat ruptured breast implants?
Ruptured breast implants are not very common, and are usually easily dealt with by an experienced plastic surgeon, especially if the problem is discovered early on.
If you have any concerns regarding your breast implants or questions you would like to Dr Carmen then please call, or book an appointment to get a full assessment.
Further Reading – Medical Sources:
Visit our Breast Surgery page for more information about Breast Implant Removal or Breast implant Replacement Surgery