4 years post op breast implants and now they are getting hard. Could something be leaking?

First if there is a change, that should be investigated.  If they were soft and now they are hard, it will likely require some surgery for capsular contracture.  

Thank you for your question.  If your implants are just now becoming hard, it may be indicative of a capsular formation around your implants.  Scar tissue around implants is the bodies natural response to the implant (foreign object) but occasionally this response is heightened and the scar tissue grows and constricts around your implant, commonly referred to as a capsular contracture.  I would recommend following up with a board-certified plastic surgeon for a complete clinical assessment.  It is possible that a physical exam may be all that's necessary but your doctor may send you for a MRI of the bilateral breasts to examine the health of your current implants or diagnosis an implant rupture.  I hope you find this helpful and best of luck!

Please see your surgeon as soon as you can. Hardening of breast implants is often indicative of capsular contracture. This is a complication that should be addressed. Best of luck. 

Unfortunately, you describe
classic capsular contracture of your breast following breast augmentation. It’s
important that you see your plastic surgeon and have a treatment plan
formulated to deal with this problem.

 

         Whenever a foreign
material is placed inside your body, it will generate a reaction from the
surrounding tissue. This typically results in a fibrous capsule that surrounds
the breast implant. When this occurs, following breast augmentation, we call it
a capsular contracture.

 

         All patients have
some capsule formation. Indeed, absence of capsule formation might result in
implants shifting. When capsule formation results in contracture, patients may
experience hardening of the breast, distortion of the breast and breast pain.

 

         Capsule formation
can occur at any time and as time goes on, this may be accompanied by pain and
progressive distortion of the breast. The breast may shift in an upward
direction and develop an abnormal shape.

 

         When capsular
contracture occurs, there are several treatment options. In mild cases, medical
management and massage may be necessary. In severe cases of capsular
contracture, surgery may be necessary. This may require release of the contracture
by performing a capsulotomy, or removal of the capsule by performing a
capsulectomy. Treatment has high satisfaction rates and most patients are
ultimately happy.  

Implants that become hard and sometimes distorted or painful have capsular contractures.  There are four grades of contractures depending upon the hardness and appearance.  The cause of capsular contractures is unknown but current thinking favors a bacterial etiology at the time of insertion.  There are some ways to try to avoid this problem.  Covering the nipple areolar complex with betadine and cleaning the incision with betadine frequently are some of the ways to try to avoid this problem.  Once the problem has occurred, if significant, then the capsules are best removed by surgical excision.