Can a 40 year silicon breast implant have micro leaks? They gave me an MRI and can't find leakage.

I am very sick & doctors don't understand why. I'm a 76 y/ o female whose had silicon breast implants in 76. I had an MRI to r/o a leak but wonder if they can be missing something. I have chronic inflammation in my lungs ( non smoker) healthy heart, no other underlying but have serious chronic fatigue ( was very busy body up to a year ago) and can't breath well. Oxygen level is ok despite feeling oxygen starved .

Doctor Answers 9

Implants might leak

Thank you for your breast implant question.

  • I am sorry about your illness.
  • You should have your implants removed without delay in my opinion.
  • You don't need an MRI to know if the old implants leaked.
  • All the older implants had gel that clearly leaked through the shell.
  • This leak may have nothing to do with your symptoms - 
  • but with an un-diagnosed illness affecting your lungs, the implants need to be removed.
  • It needs to be done with general anesthesia - there may be free silicone in the implant pocket and as much as possible should be removed.
  • Discuss with your plastic surgeon and pulmonologist if an attempt should be made to biopsy a lymph node at the time or do a lung biopsy, if one has not already been done.
  • Silicone will show up on biopsy - its absence or presence might help answer some questions.
  • Hope this helps. Best wishes.

Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

Breast Implant Possible Leak?

Thank you for your question! I personally suggest if you have any doubts with your implants that they should be removed or replaced! Best of luck!

Dr Dhaval Patel
Double Board Certified
Plastic Surgeon
Hoffman Estates
Oak Brook

Dhaval M. Patel, MD
Hoffman Estates Plastic Surgeon
4.8 out of 5 stars 93 reviews

Breast implants made before the mid nineties can have "microleaks."

Issue 1 - Microleaks: Gel bleed is common in breast implants manufactured before 1994. Implants of this age or older can allow a small amount of the filling silicone gel to migrate through the shell, like helium can get through a balloon without an obvious hole. In 1994 implant shells improved dramatically, with very low rates of gel bleed, tougher shells and improved silicone quality. 

Issue 2 - MRI detection of leaks. The best data we have shows that the MRI is 90% accurate in detecting leaks when one is suspected by a plastic surgeon. It is the most accurate test we have short of operating and checking the implant by hand.

Issue 3 - Unknown Illness. While there are been case reports of women feeling better after removing their breast implants, large studies fail to demonstrate an increased incidence of any diseases in women with breast implants. Breast implants do not seem to increase a woman's risk of connective tissue disorders in particular. Removing your breast implants does not have a statistically significant change of curing your illness.

While removing your breast implants may not help you feel better, keeping them is an elective decision. The risks and benefits need to be evaluated with a Board Certified Plastic Surgeon. Removing intact Breast Implants is relatively simple. According to your MRI, you have a 90% of them being intact; however, there is a 10% chance that your breast implants are ruptured, and this can make surgery more complicated. If you did not have the MRI, pre 1985 breast implants probably have a 50/50 chance of being ruptured, and all of them have gel bleed, and this is reason enough to seriously consider having the implants exchanged or removed.

Joseph Mele, MD
Walnut Creek Plastic Surgeon
4.5 out of 5 stars 17 reviews

Gel symptoms/leak

MRI's  can read both false positive and false negative. Yours may or may not be ruptured. If they are, it is unlikely they are responsible for your symptoms. Large studies over many years have found no credible link to to systemic diseases and symptoms like you describe. If you have any concern after that information, you could certainly opt to either replace them to be certain your implants will be intact, or remove them. Your symptoms may or may not improve.

Robert H. Hunsaker, MD
Miami Plastic Surgeon
4.5 out of 5 stars 82 reviews

MRI scan is not100% accurate in diagnosing implant rupture.

Implants that are that old of probably disintegrated. The silicone will be contained by the capsule. I would recommend that you have them removed. I don't think you will have any effect on the other symptoms that you're talking about.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 36 reviews

40 year old silicone imlants

My advice would be to remove the implants regardless of what an MRI shows.  The gel of that era has most assurdedly migrated through the shell; however, the shell has very likely ruptured.  I would say remove the implants and silicone and let yourself heal.  

Michael B. Tantillo, MD
Boston Plastic Surgeon
4.7 out of 5 stars 29 reviews

Time to replace Breast Implants

Before Cohesive gel implants were released, all of the prior models had an expiration period of ten yearsm when is time to replace them because of leaking the low density gel in a thin membrane inside the capsule. In your case just the clinical story is enough to know what to do, a replacement. In the recent cohesive models we need to do an MRI in 10 years after placement to see if they are ok.

Luis Lopez Tallaj, MD
Dominican Republic Plastic Surgeon
5.0 out of 5 stars 7 reviews

40 year old breast implants

In the cases I have seen of 40 year old implants, nearly every one was not only ruptured but disintegrated.  Sometimes if the entire capsule has degraded the MRI can miss a rupture.

It is time to replace the implants or have them removed and do a lift.

It's uncertain whether that will help your symptoms; hopefully it will, but independent of that issue, it is time to deal with the implants.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 178 reviews

40 year old silicone gel implants

An MRI although the most sensitive diagnostic study for breast implant integrity is used most often when one wants to keep the implants.  With a 40 year old implant, based on age alone, your incidence of leak or rupture within the capsule is probably 75% or higher.  So knowing this, a negative or equivocal MRI does not rule out a leak.  As an MD, I cannot comment our your medical condition as it relates to surgery, but might want to have the implants removed when your are able.

Peter J. Capizzi, MD
Charlotte Plastic Surgeon
4.9 out of 5 stars 87 reviews

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.