How Can I Definitively Determine That I Have a Slow Leak in my Saline Implant?

I have saline implants. Over the past few months one breast has gotten smaller than the other and I think I have a slow leak. I had an MRI but the radiologist said there wasn't a leak. I didn't think MR imaging would be able to show a saline leak. Are there other tests or imaging that can identify a saline leak? My PS said my implants were intact but I know one breast has definitely gotten smaller. What should I do and what other questions should I ask?

Doctor Answers 6

Leaking Saline Implants

Saline breast implants could on occasion have a very slow leak, although once saline implants start to leak they eventually completely deflate.  MRI would not be necessary to assess saline implants, but once you have them, it could be helpful in assessing if there is significant volume discrepancy.  Your surgeon should be able to tell if you have a partially deflated saline implant, as it has a different feel.  Ultimately, the most important factor is whether asymmetry bothers you enough to undergo another surgery.

Newport Beach Plastic Surgeon
4.7 out of 5 stars 56 reviews

Are My Saline Breast Implants Leaking?

Dear jellybean2011,

Breast implants, like all mechanical devices, have a very small chance of failing. A saline implant that leaks will usually become very obvious within a few days to weeks, as the affected breast will deflate. Your plastic surgeon should be able to determine whether your saline breast implants are intact by performing an examination. An MRI is usually not necessary, but if you have already had one, looking at the volume of the two breast implants should answer whether there has been any leakage. Based on the feedback you have received from your plastic surgeon and radiologist, it is unlikely that you have a leaking implant.

If you still have concerns about the possibility of leakage, consider getting a second opinion.

Also, please note that the above is *not* true if you have *silicone* implants, as opposed to saline.

Warmest wishes,

Larry Fan, MD

Larry Fan, MD
San Francisco Plastic Surgeon
4.3 out of 5 stars 14 reviews

Saline Implants

Hello Jellybean,

Who told you to get an MRI?  That was a waist of money and an inappropriate use of resources.  Saline implants generally will get smaller with time (usually days, but sometimes weeks) and become very obviously deflated.  If your plastic surgeon says they are in tact, I would trust him. If he was the one who ordered the MRI, go to another doctor for a second opinion (which might require two visits, a week or two apart so that he can assess changes.)

There can be other reasons why your breast(s) appears smaller, and patients can be deceived into thinking their breasts are either larger or smaller, when in fact something else is going on like implant migration, tissue stretch, or capsular contracture.

Best of luck.

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 89 reviews

Saline Breast Implant Leakage?

Thank you for the question. 

Leakage of saline breast implants usually becomes obvious over time;  the breast tends to become smaller and breast implants softer and/or demonstrates more rippling. Your plastic surgeon will be able to make the diagnosis upon examination. No radiographic studies are necessary.

If the implant appears to be filled,  another explanation may be that it has shifted causing the breast to appear smaller visually.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,487 reviews

Symptomatic Rupture of Saline Implants

When saline implants leak, they generally result in a "flat tire" effect. Occasionally, I have seen slow leaks from around the implant fill valve or from a pinhole defect. Although most saline implants will inevitably deflate, they may not deflate completely. Make sure that you have waited at least three months from your initial operation before you make any rash decisions. Occasionly, swelling can subside more quickly in one breast than the other. However, if you are very sure that your implant is delated, it should be removed and replaced.

Kevin Brenner, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 22 reviews

How Can I Definitively Determine That I Have a Slow Leak in my Saline Implant?

Dp photo documentation, other opinions until the doctors see the differences. I have a silicone case right now that the mammogram/ultrasound shows no leak/ But clinically even though the size feel the same I believe there is a leak. I'm recommending the patient obtain a second opinion so I can pre surgery convince the implant company she has a leak/rupture. Best

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 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.