Breast Implant Rupture: Signs, Ultrasound Diagnosis & Treatment

Breast augmentation surgery using breast implants has, for decades, been amongst the most popular and common cosmetic surgical procedures done around the world. Why is that the case? It’s because breast augmentation surgery is safe, reliable, predictable and gives patients what they’re asking for.

But even when operations are popular and successful, patients and surgeons alike still worry about certain issues. Did I choose the right implant size? Was it right to put the implant under the muscle? Was it right to put the implant over the muscle? Should I have done that breast lift at the same time? Should I have gone with a more- or less-projecting implant?

But one concern stands out above all when it comes to breast implant surgery. Patients frequently ask themselves and me:

Saline Breast Implants

When it comes to breast implant rupture, we must differentiate between old-style saline implants and newer, modern silicone gel breast implants. I don’t have much to say that is positive about saline breast implants these days, especially as compared to the current generation of excellent silicone gel devices. Most plastic surgeons believe that the era of the saline implant is over.

However, the one advantage to a saline breast implant is that if it breaks, there’s usually no mystery surrounding it. The patient and the surgeon can see an obvious and usually sudden decrease in breast size corresponding to the loss of volume from within the saline breast implant. This sudden deflation and resulting breast asymmetry usually make the decision about what to do fairly obvious. 

Usually, the best thing to do is to simply replace the broken implant. More often than not, patients will choose to remove the broken saline implant as well as the intact saline implant and replace them both with modern silicone gel implants.

Silicone Breast Implant Rupture

In this day and age of cohesive silicone gel breast implants, establishing whether or not a breast implant is ruptured isn’t always so simple. It is possible that a breast implant can have a small break in it, but the breast shape, size and feel remain the same as it always did. This is the case because of how cohesive the gel is in today’s implants. Even when it’s broken, it tends to maintain its shape and consistency.

Schedule Regular Checkups

Responsible plastic surgeons have always encouraged their breast implant patients to come back for routine postoperative care. At The Cosmetic Surgery Clinic, that means we invite all our breast implant patients back for a checkup every 2 or 3 years, forever. At those follow-up visits, we do a clinical examination, and we ask you all kinds of questions about how the breasts look and feel and whether or not you’ve noticed any changes.

In the old days, if we wanted to be 100% certain about the integrity of the breast implant, we would have to do an MRI exam. Even though waiting lists for elective MRI exams can be long, sometimes we still do them because MRI remains the gold standard to see if a breast implant is ruptured or intact.

In-Office Ultrasound Checks Are Game-Changers

I’m very happy to say that these days, there’s another, simpler alternative to an MRI exam. At The Cosmetic Surgery Clinic, we can do a quick ultrasound exam right in the clinic to look at the integrity of the implants. This is not the same kind of ultrasound that a woman would have to assess a mass or a lump in the breast or to examine a breast for the presence of breast cancer. This is a simple ultrasound test that helps us look at the implant shell in real-time and have a very high level of confidence in saying whether the implant is intact or broken. It’s a technique we’ve adopted in the clinic over the last 1 to 2 years, and we have found it incredibly valuable. 

This simple, painless and noninvasive test can really reassure our patients. It also helps with preoperative planning in revision cases. It’s always nice to know if one of the implants is ruptured before we get to the operating room.

Breast Augmentation Revision: Treatment for Ruptured Implants

But what happens if we do find a broken implant? Or if a patient finds out they have a broken implant as an incidental finding when undergoing some other investigation? 

The first thing we recommend is to come in for a visit with us as soon as possible. The simple answer to the question of what to do when faced with a ruptured implant is that we like to remove it and replace it. This is called breast augmentation revision.

Plastic surgeons don’t have a lot of research-based information about the long-term effects of leaving a ruptured silicone breast implant in place. However, what we do know is that a silicone breast implant is engineered and tested to perform in a certain way—in an intact configuration. Silicone breast implants are not designed and tested and, of course, were never intended to remain in the body in a ruptured state.

While it is certainly not a critical, life-and-death emergency to remove a ruptured implant, it’s not something that I suggest patients put off for any great length of time.

In general, removing a ruptured silicone implant, cleaning out the implant pocket within the breast, and replacing it with a new implant is a straightforward procedure that doesn’t require much in the way of breast tissue manipulation or recovery time. In general, the affected breast can look as good as it ever did with the original implant.

Finding Peace of Mind

So, if you have questions or concerns about the integrity of your breast implant, or if it’s been more than a couple of years since your last physical exam, come on in and let’s have a chat. A simple ultrasound test will point us in the right direction. Get in touch with us online or call us at (519) 746-1132 to schedule your appointment.