I've had progressive pain in my right breast that eventually spread to both. Is my implant ruptured? (w/ MRI photos)

Breast Implants and progressive pain
Although it is hard for me to interpret these films, the breasts are clearly distorted and may be ruptured.
Capsular contracture , although usually firm , can feel softer with a rupture. Also the capsule can pull on the surrounding tissues causing various types of pain including: discomfort, aching, burning. etc.

You clearly would benefit from a capsulectomy and implant exchange to provide improvement in shape contour and discomfort

I encourage you to return to your surgeon to discuss your concerns. You can be evaluated for capsular contracture and rupture. Bring along the report from the MRI for your surgeon to review.

It sounds like your concerns are coming from pain that began in the right breast and is worsening/spreading. Did your plastic surgeon order the MRI? MRI is gold standard to look for implant integrity or rupture with a greater than 90% specificity and sensitivity. The radiology read will report whether the implant is ruptured or not. If it is ruptured the read will also comment on whether it is contained in the capsule (scar tissue around the implant) which is intracapsular vs outside the capsule (extracapsular). It is difficult to interpret the photos here as I'm not a radiologist but they look for something called a linguine sign (lines seen where the shell collapses compared to the capsule or scar tissue around the shell). There are other signs as well that may show better on other images not included here. Pain can be from many things including capsular contracture (increasing tight feeling of the breast) that can sometimes only be felt on exam but when progressive can be seen as well on visual examination. Pain can also be caused by implant displacement, implant rupture and things unrelated to the implant, which could be breast related. You should return to your original plastic surgeon or other plastic surgeon specializing in breast surgery to further discuss the MRI read and for a breast exam to look for other pain etiology if implant is not ruptured.

Based on the posted MRI appears you have a ruptured implant on one side and capsule contractor bilateral. Best to do virtual in person consultation with board-certified Plastic Surgeon . Expect revision explant capsulectomy surgeries needed. Expect fees to run $10-$20,000. Regards.