Cohesive gel rupture, is it a life or death matter?

It is not a life and death matter, but that doesn't mean you should ignore this situation and ruptured implants should be removed as a standard of care practice. For silicone implants prior to 2006, ruptures occur at rates of approximately 1-2% per year for the first ten years then markedly increases after that time period. A rupture or deflation of the implant may be experienced at any point after the initial augmentation; this complication may be increased by an under-filling or overfilling of saline solution into the implant, excessive compression, trauma, and other causes. (If the implant shell if not filled with the correct amount of saline, there may be a crease or fold in the shell which often leads to a rupture). You will be able to self-diagnose the need for an implant exchange (if using a saline implant) because if the current implant ruptures, the breast will shrink to approximately its preoperative size. A silicone implant that has a rupture is usually noted on a routine mammogram or MRI scan. In either case although the situation needs to be corrected on a timely basis, it is not dangerous to your health from our current knowledge base. Silicone implants after 2006 are more cohesive and less likely to leak or have silicone migration. Although the newer implants are more cohesive they are still very sticky when ruptured and you do need a removal of the surrounding capsule (capsulectomy) if this happens vs simple implant replacement with saline implants.

Thank you for your question.  No, a gel implant rupture is not a life or death matter.  It should be replaced, however.  Discuss this in person with your plastic surgeon. Best wishes.

to the best of our knowledge of having gel in patients since the 70's, does not cause any systemic health problems.  With the newer cohesive gel implants now available, there is even less chance of the gel migrating into the adjacent tissues.  Think of the gel as similar to gelatin... holds its shape and doesn't fragment.  In my practice, I advise patients to not even worry about this if their breasts look and feel great.  The only time it becomes an issue is when the warranty on the implants change at 10 years out.

Cohesive gel implants have the issue of "silent rupture".  If or when they leak they do not tell you because the gel is not absorbed and you do not change size or shape.  It is possible that many women have a leak in their gel implants but it was determined by the FDA that there is not any toxic effect or medical illness that is caused by the implant gel.  At this time the best technology for evaluating gel implants is with an MRI.Best WishesDr. Peterson

If you have a cohesive gel rupture it is usually not a "life or death matter" but should be addressed sooner rather than later.

Please relax and see her plastic surgeon for an examination and possible MRI to check for breast implant rupture.There is no evidence that a ruptured silicone gel breast implant can cause significant systemic disease.  Many patients live with many years with silicon breast implants which have ruptured.  Typically the breast implant capsule contains the rupture within the implant pocket.  NextPlease relax and see her plastic surgeon.