Implant rupture or deflation is among the top five reasons women may require a secondary surgery (breast revision surgery) after breast augmentation. Implant rupture can happen for many reasons, but often it’s just a matter of the implant’s outer shell weakening with age. Breast implants are not lifetime devices, which is why implant warranties last only 10 years. On average, breast implants last anywhere from 10 to 20 years. Although it is conceivable they could last (and have in some women) a lifetime, it is unlikely.
Early rupture can happen for unknown reasons, or it can happen due to a number of contributing factors. These factors include damage by surgical instruments during surgery, overfilling or underfilling the implant with saline solution, umbilical incision placement, capsular contracture, physical trauma, closed capsulotomy, or even excessive compression during a mammogram.
Implant leaks can happen in silicone or saline implants when there is a break in the implant shell. Leaks can also occur in saline implants through an unsealed or damaged fill valve. (Saline implants are inserted into the body empty, then filled with saline solution through a valve on the implant once in place inside the patient’s body. Silicone implants do not have a fill valve, since they are pre-filled in the manufacturing process.)
How Do I Know if My Breast Implant Has Ruptured?
“Deflation” refers to a sudden loss of volume to an implant. Saline-filled implant deflation can occur very suddenly or happen slowly over a period of days. The result is noticeable by a loss of size or shape of the breast.
On the other hand, not all implant ruptures result in deflation. Silicone implants are filled with a gel material that does not leak in the same way that liquid saline solution does. Silicone implant ruptures may result in a slight loss of volume over time. However, silicone gel is also capable of remaining mostly inside the capsule of scar tissue that has formed around the implant. Therefore, a silicone rupture is usually not detectable without the aid of an MRI.
Today’s silicone implants have a thicker outer shell and a more cohesive gel material filling. Therefore, they may last a bit longer than saline implants. The disadvantage is that ruptures often go undetected, meaning that silicone can leak and migrate within the body. For this reason, many doctors recommend having an MRI 3 years after your surgery, and then another MRI every 2 years to detect the presence of any leak.
What About “Gummi-Bear” Implants?
Although not yet FDA-approved for consumer use, the cohesive gel (gummi-bear) implant has gotten a lot of press. The implant may answer some key concerns about silicone implant rupture, because the filler material used is of a very thick consistency and completely cohesive (meaning that, even when the implant is cut in half, the gel remains in place and will not migrate to other parts of the body). These implants are still in FDA-testing by the Inamed and Mentor corporations.
How Can I Minimize My Risk of Implant Rupture?
The truth is that sometimes there is nothing you can do. However, avoiding certain actions can reduce your risk.
Before Surgery: Talk to your surgeon about his or her surgical plan. Practices that increase your risk (some of which may even void your implants’ warranty) include the trans-umbilical approach (going through the belly button), and overfilling or underfilling of the implant. Some doctors even believe that sub-muscular implant placement (under the pectoral muscle as opposed to over the muscle) offers a certain measure of protection for your implant.
After Surgery: Avoid dangerous (high-contact) sports or other activities which carry a high risk of physical trauma to the chest area. If you get a mammogram, be sure to tell your technician beforehand that you have implants, and whether they are saline or silicone. Have an MRI every 2 to 3 years if you have silicone implants. Remember that if you should develop capsular contracture, closed capsulotomy is not a recommended method to address the problem.
Interview with Adam Tattelbaum, MD – Rockville, MD; conducted on November 14, 2008
Saline-Filled Breast Implant Surgery: Making An Informed Decision, Mentor Corporation (information provided by the U.S. Food and Drug Administration)