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

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.

It's a great question. If saline implants leak, they simply deflate, your body absorbs the saline fluid, and there are no issues. You should see a noticeable difference in your breasts over just a few days.

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.

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.

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.

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

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