Signs of Leaking Breast Implants

I've had my breast implants for about 4 years.  When I lie down my implants sometimes feel like a misshapen, hard lump.  I can also feel the implants and some soreness. Are these signs my breast implants are leaking?  How can I tell?

Doctor Answers 53

Firmness in breast

 When saline implants leak, they will deflate and become smaller. The new gels may not show any signs of leakage.  If you have a hard lump, please see your family physician or plastic surgeon.  You may have some scar tissue or capsule formation occurring, or there may be another problem.  Please do not ignore the lump.

San Antonio Plastic Surgeon
4.5 out of 5 stars 10 reviews

Depends on the implant

These do not sound like signs of leaking from a saline implant.  However, they could be associated with leaking from a silicone implant.  You need to visit with a board certified plastic surgeon, and possibly get an MRI if you have silicone implants.  Either way, it is always best to have someone examine you if you are having problems.

Soreness and lumps should always be addressed

By now, I hope your problem is resolved and that you went to see your doctor when you identified that you had a problem. In general, silicone gel filled implants need an MRI X-ray to determine if they are leaking. With saline implants, you'll know because your breasts will return to their original size and you won't fill out your clothes symmetrically. 

Ted Eisenberg, DO
Philadelphia Plastic Surgeon
5.0 out of 5 stars 11 reviews

Signs of leaking breast implants

Thank you for your question. If you have saline implant, it is very easy to tell since a rupture causes the saline to leak out and the body simply reabsorbs the "salt water". In addition the appearance of the breast rapidly decreases in size since the water is absorbed very quickly.
Silicone implants are a little more difficult to tell if they have ruptured. A ruptured silicone implant may not cause a misshapen appearance to the breast or hard lumps since the gel is cohesive and should not "leak" out. However, I have seen ruptured implants cause a "capsular contracture" which can cause the hardness you are speaking about. The best way to diagnose a ruptured implant is with an MRI. The FDA recommends an MRI every 2-3 years after a breast augmentation. However, most women do not opt to have MRIs since they are an "out-of-pocket" expense. Since you ARE having symptoms, I would recommend visiting your plastic surgeon to make a decision about ordering an MRI.

Signs of Leak

If you have saline breast implants, it's easy to tell if they are leaking.  They deflate quickly and the body harmlessly absorbs the saline so that breast looks deflated and significantly smaller then the side that is not deflated.  This usually happens over a period of a few days.

If you have silicone based implants then it is a litter harder to tell.  The new implants don't leak everywhere so they usually present as some change in the look of feel of the implant.  A breast that was completely normal for several years may begin to change in appearance or become harder or more tender.  However, because the volume remains the same, there usually isn't any obvious deflation.  The only sure way to tell is to get an ultrasound or MRI.   

If you suspect a leak then you should see a board certified plastic surgeon to determine if you need to get further testing.  If there is leak or rupture then that implant needs to be removed and exchanged for another one.

Adam Hamawy, MD
Princeton Plastic Surgeon
5.0 out of 5 stars 22 reviews

Hard lump in the breast

Changes in the feel and shape of the implants can indicate a rupture or the development of a capsular contracture.  Saline implants will deflate if ruptured but it is often difficult to tell if a silicone implant is ruptured.  

Changes in the breast and new lumps of tenderness should be evaluated by a physician.

Michelle J. Place, MD
Danville Plastic Surgeon
5.0 out of 5 stars 7 reviews

Signs of Leaking Breast Implants

If your implants are saline then they will decrease in size fairly quickly if they are ruptured.  Gel implants can be more difficult to evaluate for rupture.  What you describe is not a typical story for rupture but closer to capsular contracture.  They best evaluation for rupture for gel implants is an MRI.  Visit your plastic surgeon to discuss the problem and be evaluated.

Susan D. Vasko, MD, FACS
Columbus Plastic Surgeon
4.5 out of 5 stars 5 reviews


The occurrence of implant leakage has reduced over the years as implants have been improved. However, it can still occur especially if the chest area suffers any sort of trauma. When a saline implant ruptures or leaks, there is a notable and sometimes instant deflation of the breast making a leak easier to detect. When a silicone gel implant develops a leak it is not as easy to detect. The silicone gel inside the implant is very cohesive and so does not create a noticeable deflation of the breast. Ruptures or leaks of silicone implants typically require a CT scan to confirm. If there is a rupture, the implant will need to be removed along with any residual implant material and a new implant placed. After 4 years, it is unusual to still experience soreness after breast augmentation. Another concern is that implants should not feel hard. Hardening of an implant could be a sign of a postoperative complication called capsular contracture. Capsular contracture can only be confirmed by a physical exam so it is difficult to say definitively what you are experiencing. I recommend scheduling some time with your plastic surgeon as capsular contracture is progressive and will worsen over time.

Be well and good luck!


Signs of Leaking Breast Implants

The appearance of a leaking implant depends on whether the implant is a saline or silicone gel one.  A leaking saline implant causes the affected breast to rapidly loose volume (the "flat tire" effect), which is very obviously.  A leaking silicone gel implant is not as obvious.  It may present with hardening of the affected breast, a shape change in the breast, or no change at all ("silent rupture").   When a silicone gel implant rupture or leak is suspected, a breast ultrasound or MRI may help identify the leak.  

Paul Fortes, MD
Houston Plastic Surgeon
4.0 out of 5 stars 7 reviews

You must see your doctor or plastic surgeon to confirm.

If you have saline implants, you would know if they were leaking because your breast size would deflate. If you have silicone implants, a leak can be more difficult to detect. However, the hard lump you feel may be a symptom of capsular contraction. The only way to know for sure is to see your physician or your plastic surgeon. Best of luck.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.